Publications by authors named "Michael Joy"

The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB, RCSB.org), the US Worldwide Protein Data Bank (wwPDB, wwPDB.org) data center for the global PDB archive, provides access to the PDB data via its RCSB.

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  • - Invasive fungal disease (IFD) in the central nervous system (CNS) poses a significant risk to patients with hematological disorders, leading to severe outcomes, especially in those undergoing chemotherapy or stem cell transplants.
  • - A study analyzed 43 patients diagnosed with CNS-IFD from 2018 to 2022, identifying key clinical signs, such as sudden deterioration in sensorium, along with prevalent infections caused by Rhizopus and Aspergillus species.
  • - The study revealed a low overall survival rate of 27.9% within six months, emphasizing the critical need for early diagnosis and timely antifungal treatment to improve patient outcomes.
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Background: Tuberculosis in cattle is caused by Mycobacterium tuberculosis complex (MTBC) species. Apart from MTBC, different Nontuberculous Mycobacteria (NTM) species have also been isolated from cattle. The presence of NTM infection in bovines makes the diagnosis of bovine tuberculosis (bTB) a cumbersome task.

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  • Invasive aspergillosis (IA) is a serious infection affecting patients with blood cancers, and traditional diagnostic methods are challenging.
  • A study evaluated the effectiveness of a multiplex real-time PCR test (AsperGenius) against the standard galactomannan test for diagnosing IA in hematology patients, involving 107 participants.
  • Results showed that a combined approach using both tests improved the diagnosis of IA, with PCR and galactomannan testing together achieving better sensitivity and specificity than either method alone.
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  • Researchers looked into how to test kids under 15 for tuberculosis, a serious illness that can be missed in many children.
  • They studied data from five countries and included children who showed signs of the disease, while excluding very sick kids or those already on treatment.
  • Out of 975 kids tested, 25% were confirmed to have tuberculosis, 29% were thought to have it but not confirmed, and 46% were unlikely to have it.
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  • The study investigates the prevalence and impact of candidaemia in 67 ICUs across India, assessing how the COVID-19 pandemic influenced its rates and mortality.* -
  • Data from 401,601 patient days revealed higher candidaemia rates in COVID-19 ICUs (2.52/1000 patient days) compared to non-COVID-19 ICUs (1.05/1000 patient days), with associated mortality significantly higher in COVID-19 cases (61% vs. 41%).* -
  • Analysis identified C. tropicalis as the most common isolated species (26.7%), while C. auris, which had a high mortality rate, accounted for 17.5% of isolates
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Objective: Early surgical debridement is vital for favorable outcomes in acute invasive fungal sinusitis (AIFS). Our study aimed to propose guidelines with tailored, conservative surgical procedures based on areas of involvement and evaluate their usefulness in avoiding repeated debridement.

Methods: This retrospective observational study was conducted on 150 AIFS patients operated on with the proposed surgical guidelines from May to June 2021 at a tertiary care hospital.

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Background: Rapid detection of tuberculosis (TB) and its resistance are essential for the prompt initiation of correct drug therapy and for stopping the spread of drug-resistant TB. There is an urgent need for increased use of rapid diagnostic tests to control the threat of increased TB and multidrug-resistant TB (MDR-TB).

Methods: EMPE Diagnostics has developed a multiplex molecular diagnostic platform called mfloDx™ by combining nucleotide-specific padlock probe-dependent rolling circle amplification with sensitive lateral flow biosensors, providing visual signals, similar to a COVID-19 test.

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Objective: To describe clinicoradiological features and surgical outcomes in a series of nine patients with rhino-orbito-cerebral mucormycosis (ROCM) who presented with Pott's puffy tumor (ROCM-PPT).

Methods: The records of nine patients with ROCM-PPT seen between March 2020 and December 2021 were analysed. Clinical features, radiology, histopathology, operative findings, management and outcome were noted.

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We aimed to compare the demography, clinical profile, histopathology, fungal culture, radiology, surgery performed, medical therapy and outcomes of patients with acute invasive fungal sinusitis seen during the first and second waves of the COVID-19 pandemic by retrospectively reviewing their case records. Of 238 patients, 43(18.1%) presented during the first wave and 195(81.

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Objectives: Heteroresistant infections are defined as infections in which a mixture of drug-resistant and drug-susceptible populations are present. In (), heteroresistance poses a challenge in diagnosis and has been linked with poor treatment outcomes. We compared the analytical sensitivity of molecular methods, such as GeneXpert and whole genome sequencing (WGS) in detecting heteroresistance when compared with the 'gold standard' phenotypic assay: the agar proportion method (APM).

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Composite indices have been widely used to rank the environmental performance of nations. Such environmental indices can be useful in communicating complex information as a single value and have the potential to generate political and media awareness of environmental issues. However, poorly constructed, or poorly communicated indices, can hinder efforts to identify environmental failings, and there are considerable differences in rank among existing environmental indices.

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  • Mucormycosis, an acute fungal infection, primarily affects immunocompromised individuals, notably those with uncontrolled diabetes, and saw a surge in cases in India during the COVID-19 pandemic due to a lack of previous data on its molecular epidemiology.
  • The study involved whole genome sequencing of 50 Rhizopus spp. isolates from various patient groups (active COVID-19, recovery phase, and COVID-negative) to investigate species identification and genetic variation related to antifungal resistance.
  • Results showed all patients had acute fungal rhinosinusitis, with notable high HbA1c levels and a significant percentage on steroids; genetic analysis revealed distinct groupings of isolates and notable mutations associated
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  • Childhood tuberculosis is a significant health issue due to difficulties in diagnosing the disease, and there's a need for improved diagnostic tests using easily obtained samples.
  • The study evaluated the diagnostic accuracy of the Cepheid MTB-HR test in detecting tuberculosis in children under 15 years across multiple sites in Africa and India, analyzing results against established medical standards.
  • Although the MTB-HR test showed high specificity (90.3%), its sensitivity was modest, indicating limitations in identifying the disease, especially among children with HIV.
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Previously, anthropogenic ecological overshoot has been identified as a fundamental cause of the myriad symptoms we see around the globe today from biodiversity loss and ocean acidification to the disturbing rise in novel entities and climate change. In the present paper, we have examined this more deeply, and explore the behavioural drivers of overshoot, providing evidence that overshoot is itself a symptom of a deeper, more subversive modern crisis of human behaviour. We work to name and frame this crisis as 'the Human Behavioural Crisis' and propose the crisis be recognised globally as a critical intervention point for tackling ecological overshoot.

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Background: Few treatment options exist for patients with severe central nervous system (CNS) tuberculosis (TB) worsening due to inflammatory lesions, despite optimal antitubercular therapy (ATT) and steroids. Data regarding the efficacy and safety of infliximab in these patients are sparse.

Methods: We performed a matched retrospective cohort study based on Medical Research Council (MRC) grading system and modified Rankin Scale (mRS) scores comparing 2 groups of adults with CNS TB.

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Objectives: To evaluate the efficacy and safety of short-course intravenous amphotericin B followed by sustained release posaconazole tablets for diabetes or COVID-19-associated rhino-orbito-cerebral mucormycosis.

Methods: This prospective, pragmatic study included adults with diabetes or COVID-19-associated rhino-orbito-cerebral mucormycosis. Patients received short (7-14 days) or long (15-28 days) intravenous antifungal therapy (short intravenous antifungal treatment [SHIFT] or long intravenous antifungal treatment [LIFT], respectively) depending on the presence or absence of brain involvement.

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is a member of the complex (MTBC) and causes tuberculosis in a variety of animals, including humans in South Asia. Here, we describe the clinical features associated with 8 human cases of whole genome sequence (WGS) confirmed from a tertiary care hospital in South India during 2018-2019. The patient ages ranged from 9 to 51 years, with 5 females and 3 males included.

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Paradoxical reactions (PRs) are poorly studied complex immunological phenomena, among patients with tuberculosis (TB). When PRs involves critical structures like the central nervous system (CNS), immunomodulatory therapy is often required. Predictors for PRs in TB to pre-empt appropriate treatment strategies in high-risk groups are lacking.

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  • An estimated 1.2 million children develop tuberculosis (TB) annually, with 240,000 dying due to missed diagnoses, prompting the need for improved diagnostic tools.
  • The RaPaed-TB study aimed to evaluate the diagnostic accuracy of various TB tests by recruiting 1,000 children under 15 years from five countries and conducting thorough assessments, including symptom checks, radiography, and various sampling methods.
  • This large-scale study employs a complex methodology to determine the effectiveness of new testing strategies for enhancing TB detection in vulnerable pediatric populations, potentially leading to better healthcare outcomes.
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Background: India is endemic for Tuberculosis (TB), contributing to the world's highest number of active cases. Diabetes (DM), with its increasing burden in India, could contribute to adverse outcomes among patients with TB.

Methods: Consecutive patients with sputum smear positive pulmonary tuberculosis were included in the study.

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Background: Bacille Calmette-Guérin (BCG) adenitis is an uncommon complication following BCG vaccination. In rare cases, infants can develop other complications. Controversy exists regarding the diagnosis and management of these cases.

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Nocardiosis is a clinical and diagnostic challenge. This was a retrospective study carried out on cases of pulmonary nocardiosis presenting over 15 years. Clinical data was retrieved using the electronic patient records.

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Introduction: Cryptic aspergillosis, caused by cryptic species of , is increasingly reported in humans and causes significant morbidity and mortality in immunocompromised individuals. The main aim of this study was to describe the occurrence of this entity at a large tertiary care centre and analyse the challenges in identifying them in a routine diagnostic laboratory.

Methods: This was a retrospective case review of all patients diagnosed with cryptic species from April 2019 to February 2020.

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