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Aims: To find the Willingness To Pay (WTP) for pesticide-free vegetables by the consumers of Palakkad district in Kerala and the factors influencing the decision. Place and Duration of Study: The study was conducted in the Palakkad district of Kerala, between March 2022 and December 2022. Methodology: A sample of 80 consumers spread across the district was randomly selected. The factors influencing the WTP behaviour of the consumers were analysed using a logistic regression model with WTP as the dependent variable and annual income, awareness regarding the presence of pesticide residues, education, food habit, and type of market as exogenous variables. Results: Out of 80 respondents, 54 of them (67.50 %) expressed their WTP for pesticide-free vegetables. The logit model analysis indicated the annual income of the consumers, education level and awareness of the respondents regarding the presence of pesticide residues were significantly influencing the WTP decision. Conclusion: The positive responses from consumers towards pesticide-free vegetables could be used as a driving force for farmers to produce and market the same in the study area if they ensure proper marketing focused on awareness promoting programmes on pesticide residues and by establishing the authenticity of the produce's origin.

Global climate change has considerable implications in indian agriculture and hence food security and farmers livelihood. As a result there will be a threatened in food security. In this context, a study on “Impact of climate change on banana production in Thiruvananthapuram district of Kerala, India” was undertaken. The objective of the study was to quantify the impact of climate change on yield of banana in Thiruvananthapuram district of Kerala, India. The impact of climate change on banana production was quantified by using multiple linear regression model for Thiruvananthapuram district. Quarterly data on climatic variables such as temperature, rainfall, relative humidity and wind speed for a period of 31 years from 1991 to 2021 were taken as independent variables and that of production of banana from Thiruvananthapuram was taken as the dependent variable. To determine the growth trend and variability, CAGR and coefficient of variation were calculated for the area, production, productivity, and climatic variables. It showed that Q4 (October to December) temperature was positively influencing and significant at 1 per cent level of significance. This means that one per cent increase in temperature during Q4 will increase the production by 13.9 per cent and one per cent increase in rainfall during Q4 will increase the production of banana by 0.42 per cent due to optimum temperature and rainfall. Positive trend in the growth of area (5.35 per cent per annum) and production (2.86 per cent per annum) were observed in spite of having a negative trend in productivity (-2.36 per cent per annum). The impact of climate change has positive effect on banana production in Thiruvananthapuram district. Increase in Q4 temperature resulted in increased production of banana in the district.

Background. The COVID-19 pandemic has affected every sector of health care system including the cancer care. Objective. The purpose of the study is to analyse the impact of the current COVID‑19 pandemic on routine radiotherapy practice at a tertiary hospital of Northeast India. Methods. This is a retrospective study of all patients planned for radiotherapy at Assam Medical College, a tertiary care centre, in Assam, India from January 1, 2020 to May 31, 2020. The study samples are divided into two groups: group A – patients treated from January 1, 2020, to March 20, 2020 (pre-lockdown,) and group B – patients treated from March 21, 2020, to May 31, 2020 (lockdown). The department registration numbers of all the patients were collected from the entry register, and the respective paper files were then accessed to obtain the required data. Results. A total of 153 patients were planned for radiotherapy during the study period, of these 113 patients receiving radiotherapy in the pre-lockdown period and 40 patients receiving it in the lockdown period. The number of female patients decreased from 66 (58.40%) in the pre-lockdown period to 20 (50%) during the lockdown. The number of male patients also decreased from 47 to 20 but the proportion increased from 41.5% to 50%. The proportion of patients who completed radiotherapy was 90.8% in group B compare to 88.3% in group A. Conclusion. There was a decrease in number of cancer patients, especially female during the lockdown. The pandemic has severely disrupted every aspect of cancer care.

Aims : To assess the risk perception of pineapple farmers in the context of Covid 19. Place and Duration of the Study: Muvattupuzha block panchayat in Ernakulam district in Kerala between September 2021 to September 2022. Methodology: The data relating to the study were collected during September 2021 from 120 pineapple farmers, using a well-structured interview schedule. Based on a four-point Likert scale, a Standardized Covid -19 Risk Perception Index (SCovRPI) was developed to assess the risk perception against fourteen identified risks faced by pineapple farmers during Covid 19. Farmers were asked to score the risks based on their level of perception. Results: Realisation of low price, restrictions in transportation, low demand for pineapple in market, disruption in farming activities and non-availability of adequate hired labour are the major risks perceived by pineapple farmers during Covid 19. Conclusion: findings of the study are relevant for policymakers as they work to seek remedial measures that enhance the living standards and resilience of pineapple farmers.

Background: Obesity is a multifactorial metabolic disease characterised by excessive accumulation of triglycerides. The prevalence and morbidity rates associated with obesity are increasing tremendously, posing a significant risk to society. Pancreatic lipase (PL) is a key enzyme responsible for the digestion of dietary triglycerides; hence its inhibition is considered an attractive target in obesity. Methods: In this present work, a new series of echitamine-inspired indole-based thiazolidinedione hybrid analogues were designed, synthesized, and evaluated for their in vitro PL inhibitory potential. The nature of inhibition has been identified by enzyme kinetic analysis, whereas in silico molecular modelling tools (molecular docking and dynamic studies) were used for the identification of the mode of action at the catalytic site of PL (PDB ID: 1LPB). Fluorescence quenching was used for the identification of the interaction between the potent analogues with PL. Results: The condensation reaction of substituted indole derivatives with TZD in the presence of aqueous KOH resulted in the formation of the titled analogues. Analogues 7k and 7p displayed a potential PL inhibitory activity (IC50 = 11.36 and 11.87 μM, respectively). A competitive mode of PL inhibition was revealed in the enzyme kinetic analysis. A static quenching mechanism was exhibited by the screened agents on PL. The obtained MolDock scores were aligned with the in vitro PL inhibitory activity (Pearson’s r - 0.7575, p Conclusion: Analogue 7k exerted the potential activity, and further studies might result in novel lead molecules.

Non-Timber Forest Products (NTFPs) refer to all biological resources harvested from the forest for human use and are not having timber purposes. Two types of NTFPs such as tradable and non-tradable NTFPs are available. In international trade, tradable NTFPs are only significant. NTFPs are important components of food security and a vital source of income for the poor in many developing nations. NTFP collection accounts for almost 58 per cent of the total income earned by Kerala's tribal population. Most of the employment (54.04%) was generated by the wage sector followed by NTFP collection (33.77%). NTFPs were found to be collected and used by tribals for a variety of purposes, including food, medicine, raw materials for making implements, and as a source of income. NTFPs are marketed through various marketing channels, depending on various factors such as the product's nature, demand and proximity to the market. If co-operative societies and EDCs (Eco-Development Committees) could develop value additional units for NTFPs with the participation of indigenous groups, it ensures effective use of their spare time as well as a better livelihood through increased NTFP income.

Uterine prolapse is a type of pelvic organ prolapse where the supporting pelvic structures of uterus weakens and result in descent of uterus from its normal position. Among them, Prasramsini can be most suitably correlated with 1st and 2nd degree uterine prolapse. The management principle of pelvic organ prolapse includes Vathika yoniroga chikitsa along with Sthanika chikitsa. Treatment mainly aims at Vathasamana, Brimhana, Sandhana, Balya and strengthening of pelvic floor musculature. Sthanika chikitsa like Yonilepana, Yonipurana, Pichu dharana, etc can be done in pelvic organ prolapse. In Sthanika chikitsa, medicines are applied intravaginally. Vaginal wall and adjacent tissues are extremely vascular and this facilitates absorption of drugs through vagina. Anatomically backward position of vagina helps in self retaining of drugs for a longer duration. In the present case, Yonilepa as Sthanika chikitsa was tried. A 56 year old lady was presented with complaints of urinary incontinence, low back ache, dyspareunia and feeling of mass per vaginum. On examination, she was diagnosed with 1st degree uterine descend. USG was done to exclude other pelvic pathologies. Pap smear was done which was – ve for intraepithelial lesion or malignancy. Lodhradi lepa was applied for 7 days in 3 consecutive months. During follow up, she was relieved from symptoms like feeling of mass per vaginum, urinary incontinence, low back ache and dyspareunia. From this case report, it is evident that Yoni lepa is effective for the management of uterine prolapse.

Drawing upon 152 in-depth qualitative interviews with residents in Austria carried out in the first year of the pandemic, this article discusses how people’s experiences with COVID-19 policies reflect and reshape state–citizen relations. Coinciding with a significant government crisis, the first year of COVID-19 in Austria saw pandemic measures justified with reference to a biological, often medical understanding of health that framed disease prevention in terms of transmission reduction, often with reference to metrics such as hospitalisation rates, etc. Instead of using this biomedical frame, our interviewees, however, drew attention to biopsychosocial dimensions of the crisis and problematised the entanglements between economy and health. We call this the emergence of a biosocial notion of citizenship that is attentive to psychological, social and economic dimensions of health. Insights into the biosocial nature of pandemic citizenship open a window of opportunity for addressing long-standing social injustices.

Tropopause-overshooting convection in the midlatitudes provides a rapid transport pathway of air from the lower troposphere to the upper troposphere and lower stratosphere (UTLS), and can result in the formation of above-anvil cirrus plumes (AACPs). Recent in situ observations from the Dynamics and Chemistry of the Summer Stratosphere (DCOTSS) field campaign are used to examine impacts from active overshooting convection on UTLS composition. There are little to no prior airborne observations of active overshooting convection, making observations from this flight valuable to interpreting and exploring processes seen in idealized modeling studies. DCOTSS research flight 13 on May 31st, 2022 sampled active overshooting convection over the state of Oklahoma for more than three hours with the NASA ER-2 high-altitude research aircraft. Additionally, an AACP was bisected during this flight, providing the first such extensive sampling of this phenomena. This study aims to provide a detailed understanding of changes in the UTLS composition from active overshooting convection and AACPs using the in-situ observations from this flight. The observations reveal multiple pronounced changes in air mass composition and stratospheric hydration. In agreement with prior modeling studies, maximum altitudes of water vapor enhancement were much higher than altitudes of mostly passive trace gas composition change. Stratospheric water vapor enhancements reached nearly a factor of four over background levels at a maximum altitude of 16.56 km and a potential temperature of 389.76 K. Carbon monoxide, a tracer of tropospheric origin, showed enhancements of a factor of two over background levels at a maximum altitude of 15.76 km and potential temperature of 363.6 K. There is a notable positive correlation between water vapor and ozone near the bisection of the AACP, which seems to be the result of horizontal mixing. It appears that the water vapor enhancement within the AACP was limited to the saturation mixing ratio of the low temperature environment.

Knockdown of SCD1 and effect of an SCD1 inhibitor on sensitivity to erastin

Tumor-associated macrophages (TAM) promote triple-negative breast cancer (TNBC) progression. Here, we report BRCA1-IRIS–overexpressing (IRISOE) TNBC cells secrete high levels of GM-CSF in a hypoxia-inducible factor-1α (HIF1α)- and a NF-κB–dependent manner to recruit macrophages to IRISOE cells and polarize them to protumor M2 TAMs. GM-CSF triggered TGFβ1 expression by M2 TAMs by activating STAT5, NF-κB, and/or ERK signaling. Despite expressing high levels of TGFβ1 receptors on their surface, IRISOE TNBC cells channeled TGFβ1/TβRI/II signaling toward AKT, not SMAD, which activated stemness/EMT phenotypes. In orthotopic and syngeneic mouse models, silencing or inactivating IRIS in TNBC cells lowered the levels of circulating GM-CSF, suppressed TAM recruitment, and decreased the levels of circulating TGFβ1. Coinjecting macrophages with IRISOE TNBC cells induced earlier metastasis in athymic mice accompanied by high levels of circulating GM-CSF and TGFβ1. IRISOE TNBC cells expressed low levels of calreticulin (the “eat me” signal for macrophages) and high levels of CD47 (the “do not eat me” signal for macrophages) and PD-L1 (a T-cell inactivator) on their surface. Accordingly, IRISOE TNBC tumors had significantly few CD8+/PD-1+ cytotoxic T cells and more CD25+/FOXP3+ regulatory T cells. These data show that the bidirectional interaction between IRISOE cells and macrophages triggers an immunosuppressive microenvironment within TNBC tumors that is favorable for the generation of immune-evading/stem-like/IRISOE TNBC metastatic precursors. Inhibiting this interaction may inhibit disease progression and enhance patients' overall survival.Significance:The BRCA1-IRIS oncogene promotes breast cancer aggressiveness by recruiting macrophages and promoting their M2 polarization.

Combined treatment with an SCD1 inhibitor and ferroptosis inducer potentiates cell death in ovarian cancer cells with a mesenchymal phenotype and reduces tumor number and mass in mice with established tumors

Enlarged image of Figure 1D

IRISOE in aggressive TNBC tumors correlates with worse outcomes.

Knockdown of SCD1 increases lipid peroxidation and cell death in cells treated with a ferroptosis inducer

Supplemental Materials and Methods

Synergistic effect of SCD1 inhibitors and a ferroptosis inducer

Supplemental Table 1

Sensitivity of FT-t and FT-I cells to SCD1 inhibitors

Activation of ferroptosis, a recently described mechanism of regulated cell death, dramatically inhibits growth of ovarian cancer cells. Given the importance of lipid metabolism in ferroptosis and the key role of lipids in ovarian cancer, we examined the contribution to ferroptosis of stearoyl-CoA desaturase (SCD1, SCD), an enzyme that catalyzes the rate-limiting step in monounsaturated fatty acid synthesis in ovarian cancer cells. SCD1 was highly expressed in ovarian cancer tissue, cell lines, and a genetic model of ovarian cancer stem cells. Inhibition of SCD1 induced lipid oxidation and cell death. Conversely, overexpression of SCD or exogenous administration of its C16:1 and C18:1 products, palmitoleic acid or oleate, protected cells from death. Inhibition of SCD1 induced both ferroptosis and apoptosis. Inhibition of SCD1 decreased CoQ10, an endogenous membrane antioxidant whose depletion has been linked to ferroptosis, while concomitantly decreasing unsaturated fatty acyl chains in membrane phospholipids and increasing long-chain saturated ceramides, changes previously linked to apoptosis. Simultaneous triggering of two death pathways suggests SCD1 inhibition may be an effective component of antitumor therapy, because overcoming this dual mechanism of cell death may present a significant barrier to the emergence of drug resistance. Supporting this concept, we observed that inhibition of SCD1 significantly potentiated the antitumor effect of ferroptosis inducers in both ovarian cancer cell lines and a mouse orthotopic xenograft model. Our results suggest that the use of combined treatment with SCD1 inhibitors and ferroptosis inducers may provide a new therapeutic strategy for patients with ovarian cancer.Significance:The combination of SCD1 inhibitors and ferroptosis inducers may provide a new therapeutic strategy for the treatment of ovarian cancer patients.See related commentary by Carbone and Melino, p. 5149

We evaluate and compare the static and dynamic performances of four different 4H-SiC power MOSFETs (Conventional DMOS and UMOS, Superjunction (SJ) DMOS and UMOS FETs) from 0.6 to 10kV. The static on-state performance is determined by analytically calculating the specific on-resistance (RON,sp), while the dynamic switching performance is determined by extracting the specific gate charge (QG,sp) and switching energy loss per cycle (Esw,cycle) using 2D device simulations. It has been found that the SJ UMOS FET exhibits at least a 31% (up to 53% at 0.6kV) reduction in the RON,sp· QG,spFigure-of-Merit (FoM) compared to the SJ DMOS FET within the breakdown voltage rating range studied.

We compare the failure mechanism and performance of a silicon carbide (SiC) semi-superjunction (semi-SJ) power DMOSFET against pure SJ and conventional DMOSFET when struck by a single heavy ion. The Single-Event Burnout (SEB) failure mechanism was identified as the thermal runaway from second breakdown resulting in mesoplasma formation. The semi-SJ design shifts the mesoplasma location from the drift/substrate interface seen in the control device structures to a location along the center of the P-pillar and closer towards the DMOSFET surface, thus significantly improving the SEB threshold voltage (VSEB). The VSEB varies with pillar width and ratio of pillar thickness to drift layer thickness. A maximum value of VSEB is reached when the pillar to drift layer ratio is 0.9 and the pillar width is 2.4 μm. The semi-SJ SEB/breakdown voltage ratio is 100% and 13% higher than the pure SJ and conventional DMOSFET, respectively. Using a new Figure of Merit (FoM), which accounts for the tradeoff between VSEB and on-state performance, we find that the SiC semi-SJ DMOSFET achieves a FoM that is 1.8 and 8 times higher than SJ and conventional DMOSFET, respectively, making the semi-SJ a competitive candidate for radiation hardened applications.

MeV level aluminum implants into 4H-SiC were performed as part of superjunction diode fabrication. Measurement of resistance test structures produced resistivities well above expected values with large decreases at elevated temperatures. Capacitance-voltage measurements indicate a high activation rate of the implanted aluminum. Temperature dependent Hall measurements produce reasonable hole mobilities with acceptor ionization energies of approximately 330meV, well above the 200meV expected for low concentration aluminum doping in 4H-SiC.

We determine the effective critical breakdown field for 4H-SiC superjunction (SJ) devices and compare it to their conventional counterparts. Also, we investigate its dependence on SJ device structural parameters, such as drift layer thickness (t) and pillar width (W). In 4H-SiC SJ devices, the effective critical breakdown field was found to be around 30% lower than that of conventional devices owing to their longer ionization paths. In particular, the effective critical electric field varies as ξcr α t-1/10 and ξcr α t-1/6 for 4H-SiC SJ and conventional devices respectively but independent of pillar width and doping concentration for high aspect ratio devices (t/W > 10).

To evaluate and compare the remineralization potential of CPP-ACP, nano-hydroxyapatite, and calcium sucrose phosphate toothpaste on artificial enamel caries lesions by means of microhardness testing.Twenty sound human primary molars, extracted for therapeutic reasons were selected for this study. From each tooth, two enamel specimens were prepared and embedded in acrylic resin blocks, and each block contains five tooth samples. After polishing, the baseline hardness of the enamel surface (KHN) was determined by Knoop microhardness testing. Then the specimens were randomly assigned into four groups (Data were analyzed using pairedEnaFix (calcium sucrose phosphate) shows a maximum increase in the enamel surface microhardness followed by Acclaim (nano-HAP) and GC Tooth Mousse.Calcium Sucrose Phosphate in toothpaste strengthened the enamel more than nano hydroxyapatite and CPP-ACP, and can be an alternative to the use of fluoride toothpaste in children.Sebastian R, Paul ST, Azher U

This article provides an overview of the NASA Atmospheric Tomography (ATom) mission and a summary of selected scientific findings to date. ATom was an airborne measurements and modeling campaign aimed at characterizing the composition and chemistry of the troposphere over the most remote regions of the Pacific, Southern, Atlantic, and Arctic Oceans, and examining the impact of anthropogenic and natural emissions on a global scale. These remote regions dominate global chemical reactivity and are exceptionally important for global air quality and climate. ATom data provide the in situ measurements needed to understand the range of chemical species and their reactions, and to test satellite remote sensing observations and global models over large regions of the remote atmosphere. Lack of data in these regions, particularly over the oceans, has limited our understanding of how atmospheric composition is changing in response to shifting anthropogenic emissions and physical climate change. ATom was designed as a global-scale tomographic sampling mission with extensive geographic and seasonal coverage, tropospheric vertical profiling, and detailed speciation of reactive compounds and pollution tracers. ATom flew the NASA DC-8 research aircraft over four seasons to collect a comprehensive suite of measurements of gases, aerosols, and radical species from the remote troposphere and lower stratosphere on four global circuits from 2016 to 2018. Flights maintained near-continuous vertical profiling of 0.15–13-km altitudes on long meridional transects of the Pacific and Atlantic Ocean basins. Analysis and modeling of ATom data have led to the significant early findings highlighted here.

A novel series of indolyl oxoacetamide-quinazolinone hybrid analogues (9aa–9df) were designed, synthesized, and evaluated for their in vitro pancreatic lipase (PL) inhibitory potential that may lead to efficient anti-obesity agents.

Background Tooth brushing behaviours in children have been significantly associated with their oral health status and susceptibility to dental caries. Adoption of proper and consistent tooth brushing habits early in life will help in establishing the same in their adulthood. Therefore this study aimed to understand and assess the tooth brushing habits of preschool children in Bengaluru city Karnataka.Methodology Primary caregivers of 102 preschool children from selected preschools in Bengaluru were included in the study. A self-administered questionnaire was distributed and the responses were collected. The questionnaire consisted of questions pertaining to demographic information of both the child and the parents and questions regarding the tooth brushing habits of children. All the responses were tabulated and subjected to statistical analysis.Results It was noted that 60 of the primary caregivers introduced tooth brushing to their children from 6 months to 1 year of age which coincided with the time of eruption of the first tooth in the oral cavity. The majority of the children 61 did not brush their teeth twice daily and this showed a significant association with the frequency of brushing of mothers with 59 of mothers reporting to brushing their teeth once a day. It was reported that 58 of the pre-schoolers brushed their teeth on their own without any adult supervision. It was alarming to see that 70 of the caregivers did not receive any information or education pertaining to the maintenance of oral hygiene in their children.Conclusion The results of this study highlight the urgent need for the establishment of proper oral hygiene habits in young children as this behaviour is amenable to change leading to a positive impact on oral health.

Background Smartwatches with various alert systems are becoming increasingly popular in the detection of atrial fibrillation (AF) post stroke, however their impact on psychological well-being remains unknown. Purpose Assess the association between smartwatch alerts for detected atrial fibrillation in older stroke survivors and patient activation as well as health-related quality-of-life. Methods Data were used from the Pulsewatch study, a multiphase, randomized controlled trial, which enrolled older adults (≥50 years of age) from the UMass Memorial Health System with history of a stroke and no contraindications to anticoagulation, who were given a smartwatch for AF detection. In Phase I, participants were randomized 3:1 (intervention:control) to receive a smartwatch/smartphone pair and an FDA-approved cardiac patch monitor or only the patch (control) to monitor for AF for 14 days. In Phase II, participants were re-randomized 1:1, with the intervention group being offered the smartwatch/smartphone pair for an extra 30 days. Participants were grouped into those receiving at least one alert of a possible abnormal rhythm versus those who did not receive any alerts from their smartwatch. At baseline, 14 days, and 44 days the Consumer Health Activation Index was used to assess patient activation and the Physical and Mental Component Summary of Short-Form Health Survey were utilized to evaluate physical and mental health-related quality-of-life, respectively. Mixed-effects repeated measures linear regression models were used to examine changes in patient activation and physical and mental health-related quality-of-life, in relation to alerts, adjusting for confounding variables including age, sex, race, history of arrhythmias, history of congestive heart failure, history of coronary artery disease, baseline depression, and baseline cognitive impairment, over the study period. Results 94 participants (64.6±9.1 years of age, 87.2% non-Hispanic white, and 43.6% female) were included in the analysis; 16 of whom received at least one alert. Specifically, twelve participants received 1 to 3 alerts, three participants received 11 to 18, and one participant received 226. In fully adjusted models, receiving alerts was not associated with changes in patient activation or mental health-related quality-of-life (β −1.70, p-value 0.60 and β 2.85, p-value 0.09 respectively), but was associated with a significant reduction in physical health-related quality-of-life (β −4.67, p-value 0.04). Conclusions In a cohort of older stroke survivors who wore smartwatches for up to 44 days, reception of alerts was not significantly associated with changes in patient activation or mental health-related quality-of-life but was significantly related to a decline in physical health-related quality-of-life. Further studies are necessary to explore the use of smartwatches in AF screening and their impact on psychological health and quality-of-life. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): R01HL137734 from the National Heart, Lung, and Blood Institute

An economic analysis of banana cultivation was done to compare the adopters and non-adopters of WBCIS. Firstly, a comparison of farm business analysis was done using cost concepts. At Cost C, insured farmers had incurred more cost (₹ 3,86,021 ha-1) than uninsured farmers (₹3,50,910.06 ha-1). The net returns at Cost C for insured farmers were ₹3,56,261 ha-1 and for uninsured farmers, it was 3,24,197 ha-1. Insured farmers had incurred more cost C and more net return at Cost C than uninsured farmers. The BC ratio obtained for insured farmers (2.01) at Cost C were more than that of uninsured farmers (1.92). It was found that the insured farmers were having more economic benefits than uninsured farmers from banana cultivation. The results of Cobb-Douglas production function revealed that R2 value for insured and uninsured farmers was 0.87 and 0.79 respectively, which indicated a good fit. The analysis of allocative efficiency, for insured and uninsured farmers, revealed that quantity of hired labour, family labour and quantity of manures, fertilizers and soil ameliorants were underutilized. Furthermore, quantity of plant protection materials was overutilized by both categories of farmers.

The vulnerability of farmers to climate variability is an important topic of discussion. It varies depending upon diverse factors that disturbing it, likewise, the extent of vulnerability varies according to different levels, i.e.; from a whole country level to an individual level or in other words from macro to micro level. This study attempts to build a framework for the assessment of the microlevel vulnerability of farmers. A vulnerability index was made from normalized values of three major component indices (sensitivity, exposure, and adaptive capacity), which is made up of a selected number of sub components. The study was conducted by selecting respondents from two districts of Kerala, and it was found that this method can be used as an empirical method to interpret the vulnerability to climate variability, keeping the fact that it is only a constrained measure of risk.

A workshop on mandatory vaccination was pitched to the World Public Health Congress in 2019 and the resultant special issue was pitched to Vaccine in 2020. During this project, the COVID-19 pandemic pushed vaccine policy to the forefront of global public health policy, and the imposition of vaccine mandates prompted a new wave of scholarship in the field. This introductory article employs the heuristic of Lasswell's (1956) policy cycle to synthesise the findings of the articles in the special issue. It considers the temporal lifetime of mandates and highlights findings regarding: the emergence of mandates as a policy option, public support and policy instrument design, what matters in the implementation of mandates, and what we can learn from evaluating them. The second half of the paper categorizes the included papers in terms of what aspects of mandates they study and the methods they employ to do so, in order to formulate a guide for future researchers of vaccine mandates. Scholars study either speculative or existing mandates - research can address several stages of the policy cycle or just one of them, ranging from attitudinal research to implementation studies and impact studies. Historical and contextual studies that take deep dives into a particular mandate are a much needed resource for studying emerging mandates, too, and scoping and framework- building work will undoubtedly be valuable in understanding and appreciating the wealth of knowledge production in this growing field. This special issue can serve as a roadmap for a consolidation of this interdisciplinary research agenda, and provide a helpful resource for decisionmakers at this historical juncture.

Background Ventricular fibrillation (VF) is common in acute ST segment elevation myocardial infarction (STEMI) and is associated with increased in-hospital mortality rate. Purpose We sought to investigate the association between VF and artery involved in STEMI Methods This is a retrospective observational study of hospitalizations between January 1, 2016 and December 31, 2019, using the National Inpatient Sample (NIS), the largest all-payer public database of hospital care in the United States. Results A total of 138,201 patients were primarily hospitalized for STEMI from 2016 to 2019. Among them 12,318 had right coronary artery (RCA) lesions, 427 had left main (LM) lesions, 2381 had left circumflex (LCx) lesions and 12,765 had left anterior descending (LAD) lesions. Mean age of patients with VF and STEMI was 62 years and that with RCA (63 years), LM (65 years), LCx (62 years), LAD (60 years), p Conclusion Highest in-hospital mortality was observed in patients with STEMI who had VF in LCx, followed by RCA and LM. There was higher occurrence of VF in STEMI involving LM. Funding Acknowledgement Type of funding sources: None.

Background Cardiac Amyloidosis is often misdiagnosed due to its non-specific presenting symptoms. There is a lack of evidence on the clinical outcomes in patients with cardiac amyloidosis undergoing transcatheter aortic valve replacement (TAVR). Purpose To study periprocedural outcomes in patients hospitalised primarily for TAVR with and without cardiac amyloidosis. Methods This is a retrospective observational study involving index hospitalizations for TAVR between January 1, 2016 to December 31, 2019 from the National Inpatient Sample (NIS), the largest all-payer public database of hospital care data in the United States. Our study sample included discharged adult patients (≥18 years) primarily hospitalised for TAVR using ICD-10 codes. Confounders were adjusted using multivariable regression analysis. Results During 2016–2019, there were 43270 principal hospitalizations (unweighted sample) identified for TAVR, among them 4999 patients had a history of cardiac amyloidosis. Mean age was 79.3±8.4 years. Among patients hospitalised for TAVR, 54.4% (n=23539) were males, 45.6% (n=19731) were females (p After undergoing TAVR, compared to the non-cardiac amyloidosis cohort, the cardiac amyloidosis cohort had less females (27.8% vs 45.6%, p=0.01), had similar age (mean age: 80.2 vs 79.3; p=0.665), higher incidence of congestive heart failure (CHF) (100% vs 74%, p=0.012), higher mechanical ventilation requirement (11.1% vs 1.5%, p=0.001)) but with a similar length of hospital stay (3.9% vs 3.9%, p=0.99). Multivariate regression analysis revealed that TAVR in cardiac amyloidosis cohort did not significantly increase the odds of in-hospital mortality than the non-cardiac amyloidosis cohort (aOR: 5.2; 95% CI: 0.7, 38.3; p=0.103). However, females had higher odds of mortality post-TAVR compared to males (aOR: 1.45; 95% CI: 1.22, 1.73; p Conclusions After TAVR, cardiac amyloidosis is associated with higher incidence of CHF increased need for mechanical ventilation, similar in-hospital mortality rate in comparison to non-cardiac amyloidosis cohort. There was an increasing trend in the index hospitalizations for TAVR with cardiac amyloidosis from 2016–2019. Funding Acknowledgement Type of funding sources: None.

There is a weak relationship between clinical and self-reported speech perception outcomes in cochlear implant (CI) listeners. Such poor correspondence may be due to differences in clinical and “real-world” listening environments and stimuli. Speech in the real world is often accompanied by visual cues, background environmental noise, and is generally in a conversational context, all factors that could affect listening demand. Thus, our objectives were to determine if brain responses to naturalistic speech could index speech perception and listening demand in CI users. Accordingly, we recorded high-density electroencephalogram (EEG) while CI users listened/watched a naturalistic stimulus (i.e., the television show, “The Office”). We used continuous EEG to quantify “speech neural tracking” (i.e., TRFs, temporal response functions) to the show’s soundtrack and 8–12 Hz (alpha) brain rhythms commonly related to listening effort. Background noise at three different signal-to-noise ratios (SNRs), +5, +10, and +15 dB were presented to vary the difficulty of following the television show, mimicking a natural noisy environment. The task also included an audio-only (no video) condition. After each condition, participants subjectively rated listening demand and the degree of words and conversations they felt they understood. Fifteen CI users reported progressively higher degrees of listening demand and less words and conversation with increasing background noise. Listening demand and conversation understanding in the audio-only condition was comparable to that of the highest noise condition (+5 dB). Increasing background noise affected speech neural tracking at a group level, in addition to eliciting strong individual differences. Mixed effect modeling showed that listening demand and conversation understanding were correlated to early cortical speech tracking, such that high demand and low conversation understanding occurred with lower amplitude TRFs. In the high noise condition, greater listening demand was negatively correlated to parietal alpha power, where higher demand was related to lower alpha power. No significant correlations were observed between TRF/alpha and clinical speech perception scores. These results are similar to previous findings showing little relationship between clinical speech perception and quality-of-life in CI users. However, physiological responses to complex natural speech may provide an objective measure of aspects of quality-of-life measures like self-perceived listening demand.

There is a weak relationship between clinical and self-reported speech perception outcomes in cochlear implant (CI) listeners. Such poor correspondence may be due to differences in clinical and “real-world” listening environments and stimuli. Speech sounds in the real world are often accompanied by visual cues, background environmental noise and is generally in the context of a connected conversation. The aims of this study were to determine if brain responses to naturalistic speech could index speech perception and listening demand in CI users. Accordingly, we recorded high density EEG while CI users listened/watched a naturalistic stimulus (i.e., the television show, “The Office”). We used continuous EEG to quantify “speech neural tracking” (i.e., TRFs, temporal response functions) to the television show audio track and additionally 8–12 Hz (alpha) brain rhythms commonly related to listening effort. Background noise at three different signal-to-noise ratios (SNRs), +5, +10, and +15 dB were presented to vary the difficulty of following the television show mimicking a natural noisy environment. The task included an additional condition of audio-only (no video). After each condition, participants subjectively rated listening demand and the degree of words and conversations they felt they could understand. Fifteen CI users reported progressively higher degrees of listening demand and less words and conversation with increasing background noise. Listening demand and conversation understanding in the audio-only condition was comparable to that of the highest noise condition (+5 dB). The addition of the background noise reduced the degree of speech neural tracking. Mixed effect modeling showed that listening demand and conversation understanding were correlated to cortical speech tracking such that high demand and low conversation understanding lower associated with lower amplitude TRFs. In the high noise condition, greater listening demand was negatively correlated to parietal alpha power such that higher demand was related to lower alpha power. No significant correlations were observed between TRF/alpha and clinical speech perception scores. These results are similar to previous findings showing little relationship between speech perception and quality of life in CI users. However, the physiological responses to complex natural speech may anticipate aspects of quality-of-life measures such as self-perceived listening demand.

Objectives The aim is to review the status of diagnostic imaging training in the English-speaking Caribbean region and to identify gaps, and opportunities for growth. Key findings Currently, there are only three training programmes within the English-speaking Caribbean that offer a Bachelor of Science degree in Diagnostic Imaging (DI) (Radiography). Despite the demand for DI services related to the growing prevalence of chronic non-communicable diseases and an ageing Caribbean population, access to such services is very limited. While there is a gap to be closed in terms of training numbers it is clear that there is also a need to develop a wider range of competencies in other modalities beyond conventional X-ray. Conclusion The English-speaking Caribbean is relatively underserved in terms of access to diagnostic imaging services. Current training programmes are limited in scope and enrolment. There is a need to address the training gaps within the region, as this is a significant opportunity for growth in this area of health professions education. Implications for practice While there is a clear rationale to support expanding and diversifying training, there is still relatively low investment in DI training. The way ahead for the Caribbean must be through enforcement of legislation, strong leadership and advocacy for training initiatives and partnership between educators and service providers.

Aim and objective The objective of this study was to evaluate and compare the antimicrobial efficacy of low-fluoride and fluoride-free dentifrices against Streptococcus mutans. Materials and methods The antimicrobial efficacy of four commercially available low-fluoride child formula dentifrices and four fluoride-free dentifrices against S. mutans was determined using the agar diffusion test. Fifty microliters of various dilutions (1:1, 1:2, 1:4) of each dentifrice were inoculated on the assigned plates under aseptic conditions. Saline was taken as negative control and 0.2% chlorhexidine was considered as a positive control. The plates were incubated at 37°C for 24 hours and the zone of inhibition around the wells was measured. Results All the tested low-fluoride dentifrices showed varying degrees of antimicrobial activity against S. mutans with F2 (Pediflor®) and F4 (Cheerio™) showing greater zones of inhibition when compared to F1 (Colgate®kids) and F3 (Kidodent). When the mean zones of inhibition produced by non-fluoridated dentifrices were compared with that of fluoridated dentifrices, no statistically significant difference was noted between NF1, NF3, NF4, and F2, F4. The antibacterial activity of F1 and F3 was significantly lower when compared to others. However, no antibacterial activity was noted with NF2. Conclusion Both low-fluoride and fluoride-free formulations tested in the study exhibited antimicrobial activity against S. mutans. In very young children where the risk of fluorosis is of concern, fluoride-free formulations can be considered as safe alternatives to fluoride formulations. Clinical significance Several dentifrices, both fluoride-free and low-fluoride formulations, are being aggressively marketed for young children. Though these toothpastes are being very commonly used by young parents for their infants and toddlers, there is very little published literature available on their antimicrobial activity and this study focuses on addressing this. How to cite this article Reddy D, Selvan A, Paul ST, et al. Antimicrobial Efficacy of Commercially Available Low-fluoride and Fluoride-free Dentifrices for Children. Int J Clin Pediatr Dent 2021;14(2):183-186.