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Despite multiple global commitments to protect the rights of people with disabilities, discriminatory attitudes and social norms continue to disadvantage children with disabilities (CWD) in various ways. This manuscript examines the conceptualisation and measurement of discriminatory attitudes and social norms towards to CWD. A systematic review of the literature was conducted across three databases. Peer-reviewed or grey literature published between 2005 and 2016 in English was included. Quality assessment was conducted for 44 articles. Overall, 45% were assessed as low quality, 7% were assessed as high quality, 57% had an explicit conceptual framework, 52% did not outline any definitions, and 7% involved participants in the research. The most commonly used scales were the Chedoke-McMaster Attitudes towards Children with Handicaps Scale (9%), the Attitude Towards Disabled Person Scale (6.8%), and the Opinions Relative to Integration scale (6.8%). The results demonstrate a general lack of clear definitions, methodological rigour in selecting participants, and beneficiary involvement in programming and evaluation. More efforts are needed to define the psychometric properties of key constructs and the language describing attitudes in commonly used scales requires significant updating. Overall, there is little evidence regarding measurement of discriminatory social norms against CWD. Several best practices for future research are discussed.

Background: Urdbean (2n=2x=22), also known as blackgram is an important short duration legume crop belonging to family Fabaceae, widely cultivated in Asia. Urdbean occupies an important position among pulses owing to its high seed protein (25-26%), carbohydrates (60%), fat (15%), minerals, amino acids and vitamins. Owing to its low water requirement, it is also suitable for rainfed conditions. It adapts well to various cropping systems owing to its ability to fix atmospheric nitrogen in symbiosis with soil bacteria, rapid growth and early maturity. Half diallel analysis was adopted in present study to gather information on gca (general combining abilities) and sca (specific combining abilities) of 6 diverse parents and simultaneously estimating various types of gene effects involved in the expression of seed yield and related attributes in urdbean. Methods: The F1's were developed during 2017 in 9 × 9 half diallel fashion by Sharma (2019) and these F1's were evaluated. Significant crosses on the basis of gene action and combining ability were selected for further advancement. The experimental material comprised of the six parents and 15 F2's of a 6 × 6 half diallel cross among six cultivars of urdbean (four are purelines viz., Palampur-93, HPBU-111, DU-1 and KU-553 and rest of the two are advanced and indigenous lines viz., Him Mash-1 and IC-281994). The F2's along with the parental genotypes were grown in a randomized block design (RBD) with three replications at Experimental Farm of the Department of Crop Improvement, COA, CSK HPKV Palampur (H.P.) during Kharif, 2018. Result: The cross combination, Him Mash-1 × HPBU-111, was identified the best for high seed yield on the basis of sca. The specific crosses, Palampur-93 × IC-281994, Palampur-93 × KU-553 were good specific combiners for most of the traits viz., plant height, branches per plant, pods per plant, biological yield per plant, seed yield per plant, harvest index, 100-seed weight and crude protein content. [ABSTRACT FROM AUTHOR]

Main conclusion: Emerging insights in buckwheat molecular genetics allow the integration of genomics driven breeding to revive this ancient crop of immense nutraceutical potential from Asia. Out of several thousand known edible plant species, only four crops-rice, wheat, maize and potato provide the largest proportion of daily nutrition to billions of people. While these crops are the primary supplier of carbohydrates, they lack essential amino acids and minerals for a balanced nutrition. The overdependence on only few crops makes the future cropping systems vulnerable to the predicted climate change. Diversifying food resources through incorporation of orphan or minor crops in modern cropping systems is one potential strategy to improve the nutritional security and mitigate the hostile weather patterns. One such crop is buckwheat, which can contribute to the agricultural sustainability as it grows in a wide range of environments, requires relatively low inputs and possess balanced amino acid and micronutrient profiles. Additionally, gluten-free nature of protein and nutraceutical properties of secondary metabolites make the crop a healthy alternative of wheat-based diet in developed countries. Despite enormous potential, efforts for the genetic improvement of buckwheat are considerably lagged behind the conventional cereal crops. With the draft genome sequences in hand, there is a great scope to speed up the progress of genetic improvement of buckwheat. This article outlines the state of the art in buckwheat research and provides concrete perspectives how modern breeding approaches can be implemented to accelerate the genetic gain. Our suggestions are transferable to many minor and underutilized crops to address the issue of limited genetic gain and low productivity. [ABSTRACT FROM AUTHOR]

The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. [ABSTRACT FROM AUTHOR]

• A set of 186 finger millet accessions showed wide variation for blast resistance. • GBS generated 2977 high quality SNPs and identified three subpopulations. • GWAS identified 132 & 4 markers for agronomic traits and blast resistance. • Markers for agronomic traits had putative role in photosystem electron transport. • Blast resistance markers showed homology with candidate genes having role in disease resistance. Finger millet (Eleusine coracana L.) is climate resilient minor millet of Asia and Africa with wide adaptation and unparallel nutritional profile. To date, genomic resources available in finger millet are scanty and genetic control of agronomic traits remains elusive. Here, a collection of eco-geographically diverse 186 genotypes was quantified for variation in 13 agronomic traits and reaction to blast to identify marker-trait associations (MTAs) using genotyping-by-sequencing (GBS) and genome-wide association study (GWAS). GBS generated 2977 high quality single nucleotide polymorphism (SNPs) markers and identified three subpopulations with varying admixture levels. General linear and mixed model approaches of GWAS to correct for population structure and genetic relatedness identified 132 common MTAs for agronomic traits across the years. The phenotypic variance explained by the makers varied from 4.8% (TP692389-flag leaf width) to 20% (TP714446-green fodder weight). Of these, 26 MTAs showed homology with candidate genes having role in plant growth, development and photosynthesis in the genomes of foxtail millet, rice, maize, wheat and barley. We also found 4 common MTAs for neck blast resistance, which explained 5.9–15.1% phenotypic variance. Three MTAs for neck blast resistance showed orthologues in related genera having putative functions in pathogen defense in plants. The results of this work lay a foundation for understanding the genetic architecture of agronomic traits and blast resistance in finger millet and provide a framework for genomics assisted breeding. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Ulcerative colitis occurs worldwide. It is considered common in most of Europe and North America and uncommon in most of the developing Asian countries. The incidence/prevalence of ulcerative colitis varies not only according to geographical region but also with race and ethnicity. There are no reported data from India on the incidence of the disease and its prevalence. Material and methods: A house to house survey was conducted by questionnaire, formulated to enquire about symptoms that are suggestive of ulcerative colitis. Those with prolonged diarrhoea with or without rectal bleeding were considered as suspected cases. These suspected cases were subjected to video sigmoidoscopy/colonoscopy and rectal biopsy. In addition, patients already diagnosed and receiving treatment for ulcerative colitis, encountered during the survey, were reviewed. Resurvey of the same areas was conducted after a one year interval to detect new cases. Using direct methods, standardised rates were calculated using world standard population weights 22, 18, 16, 12, 12, 9, 7, 3, and 1 for each 10 year age group. Standardised rates were also obtained separately for males, females, and combined populations, using the Punjab state 1991 population census data. Rates were also estimated according to UK 2000 population data. Ninety five per cent confidence intervals (95% CI) of prevalence and incidence rates of ulcerative colitis were estimated under the assumption that the distribution of cases followed a Poisson probability model. RESULTS: A total population of 51 910 were screened from January to March 1999. We identified 147 suspected cases and of these 23 were finally established as ulcerative colitis cases, giving a crude prevalence rate of 44.3 per 100 000 inhabitants (95% CI 29.4-66.6). A second visit to the same areas after one year identified 10 suspected cases in a population of 49 834. Of these, three were confirmed as "definite" ulcerative colitis giving a crude incidence rate of 6.02 cases per 100 000 inhabitants (95% CI 1.2-17.6). CONCLUSIONS: This is the first population based study from India reporting on the incidence and prevalence of ulcerative colitis. The disease frequency is not much less than that reported from Europe and North America. [ABSTRACT FROM AUTHOR]

Garden pea (Pisum sativum L.) is an important crop to growers of the northwestern Himalayas. The commercial varieties used are susceptible to powdery mildew disease. Reduction of yield quantity and quality, nutritive value of fresh green pods, and income to growers could occur as a result of infection. Consumer preference is for long, dark green pods with a high shelling percentage. Gene action for green pod yield and its component traits in garden pea were studied using a triple test cross-analysis. The objective was to determine the nature and magnitude of genetic effects for different biometrical traits that could lead to further improvement of quantity and quality of green pea pods through breeding. Ten lines of garden pea were crossed with three testers following a triple test cross method. The 30 triple test progenies were evaluated at Kukumseri (high hill, dry, temperate zone) and Palampur (mid-hill, wet, temperate zone) during summer 2004 and winter 2004-2005, respectively. Epistasis was detected for the majority of traits at both locations. Mean squares due to sums and differences were significant for most traits at both locations except pod length at Kukumseri (sums) and shelling percentage at both locations and seeds/pod at Kukumseri (differences). Average degree of dominance was in the range of partial dominance for most traits. The directional element was nonsignificant indicating the ambidirectional nature of dominance for the majority of traits at one, or both, locations, which implied that alleles with increasing and decreasing effects appears to be dominant and recessive to the same extent. The presence of j + 1 type of epistasis (homozygote x heterozygote and hetrozygote x hetrozygote) for a majority of traits can be exploited to develop improved lines by adopting reciprocal recurrent selection and diallel selective mating design. [ABSTRACT FROM AUTHOR]

Laparoscopic sleeve gastrectomy ( LSG) is the most common bariatric procedure performed in Asia. Staple-line leaks post LSG are notoriously difficult to treat. Here we report a case of a gastro-colic fistula after a post- LSG leak. While reperforming laparoscopy and/or stenting remain the mainstay of early leak management, chronic complications such as a gastro-colic fistula are rare and require a tailor-made approach. Stenting alone has a limited role in managing chronic fistulas after LSG. [ABSTRACT FROM AUTHOR]

Background & Aims: There is increasing interest in identifying patients with chronic hepatitis C genotype 2 or 3 infection in whom it is possible to lower the burden of therapy while retaining high levels of efficacy. Methods: Treatment-naive patients with chronic hepatitis C genotype 2/3 infection were randomized to receive peginterferon alfa-2b (1.5μg/kg/wk) for 24weeks (group A); peginterferon alfa-2b (1.0μg/kg/wk) for 24weeks (group B); or peginterferon alfa-2b (1.5μg/kg/wk) for 16weeks (group C), each in combination with weight-based ribavirin (800–1200mg/d). The study population comprised two cohorts: the Hep-Net cohort enrolled in Germany and an International cohort enrolled at study sites throughout Europe and Asia. The primary end point was sustained virological response (SVR). Results: The study included 682 patients; 80.2% had genotype 3 infection. In the intent-to-treat population, SVR rates were 66.5%, 64.3%, and 56.6% in groups A, B, and C, and were similar in Asian and white patients. Treatment differences (A vs. B and A vs. C) failed to reach the predefined margin for noninferiority of -10%; and thus groups B and C failed to show noninferiority relative to group A. Among patients with undetectable HCV RNA at week 4, SVR rates were 75.3%, 75.9%, and 72.4%, respectively. Relapse rates were 17.8%, 16.3%, and 29.3%, respectively. Treatment-emergent serious adverse events were highest in group A and lowest in group C, and adverse events leading to discontinuation were similar across treatment arms. Conclusions: For patients with chronic hepatitis C genotype 2/3 infection, 24weeks of peginterferon alfa-2b (1.5μg/kg/wk) plus weight-based ribavirin remains a standard-of-care therapy; however, treatment for 16weeks may be considered for patients with undetectable HCV RNA at week 4 of the treatment. [ABSTRACT FROM AUTHOR]

Objectives: Acute insults from viruses, infections, or alcohol are established causes of decompensation leading to acute-on-chronic liver failure (ACLF). Information regarding drugs as triggers of ACLF is lacking. We examined data regarding drugs producing ACLF and analyzed clinical features, laboratory characteristics, outcome, and predictors of mortality in patients with drug-induced ACLF., Methods: We identified drugs as precipitants of ACLF among prospective cohort of patients with ACLF from the Asian Pacific Association of Study of Liver (APASL) ACLF Research Consortium (AARC) database. Drugs were considered precipitants after exclusion of known causes together with a temporal association between exposure and decompensation. Outcome was defined as death from decompensation., Results: Of the 3,132 patients with ACLF, drugs were implicated as a cause in 329 (10.5%, mean age 47 years, 65% men) and other nondrug causes in 2,803 (89.5%) (group B). Complementary and alternative medications (71.7%) were the commonest insult, followed by combination antituberculosis therapy drugs (27.3%). Alcoholic liver disease (28.6%), cryptogenic liver disease (25.5%), and non-alcoholic steatohepatitis (NASH) (16.7%) were common causes of underlying liver diseases. Patients with drug-induced ACLF had jaundice (100%), ascites (88%), encephalopathy (46.5%), high Model for End-Stage Liver Disease (MELD) (30.2), and Child-Turcotte-Pugh score (12.1). The overall 90-day mortality was higher in drug-induced (46.5%) than in non-drug-induced ACLF (38.8%) (P = 0.007). The Cox regression model identified arterial lactate (P < 0.001) and total bilirubin (P = 0.008) as predictors of mortality., Discussion: Drugs are important identifiable causes of ACLF in Asia-Pacific countries, predominantly from complementary and alternative medications, followed by antituberculosis drugs. Encephalopathy, bilirubin, blood urea, lactate, and international normalized ratio (INR) predict mortality in drug-induced ACLF.

Introduction: These Asian Working Group guidelines on diet in inflammatory bowel disease (IBD) present a multidisciplinary focus on clinical nutrition in IBD in Asian countries., Methodology: The guidelines are based on evidence from existing published literature; however, if objective data were lacking or inconclusive, expert opinion was considered. The conclusions and 38 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required., Results: Diet has an important role in IBD pathogenesis, and an increase in the incidence of IBD in Asian countries has paralleled changes in the dietary patterns. The present consensus endeavors to address the following topics in relation to IBD: (i) role of diet in the pathogenesis; (ii) diet as a therapy; (iii) malnutrition and nutritional assessment of the patients; (iv) dietary recommendations; (v) nutritional rehabilitation; and (vi) nutrition in special situations like surgery, pregnancy, and lactation., Conclusions: Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations.

Background and Aim: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients., Patients and Methods: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of acute on chronic liver failure patients (n=997)., Results: Factors significant for P component were serum creatinine[(≥2 mg/dL)OR 4.52, 95% CI (3.67-5.30)], bilirubin [(<12 mg/dL,OR 1) vs (12-30 mg/dL,OR 1.45, 95% 1.1-2.63) vs (≥30 mg/dL,OR 2.6, 95% CI 1.3-5.2)], serum potassium [(<3 mmol/LOR-1) vs (3-4.9 mmol/L,OR 2.7, 95% CI 1.05-1.97) vs (≥5 mmol/L,OR 4.34, 95% CI 1.67-11.3)] and blood urea (OR 3.73, 95% CI 2.5-5.5); for I component nephrotoxic medications (OR-9.86, 95% CI 3.2-30.8); for R component,Systemic Inflammatory Response Syndrome,(OR-2.14, 95% CI 1.4-3.3); for O component, Circulatory failure (OR-3.5, 95% CI 2.2-5.5). The PIRO score predicted acute kidney injury with C-index of 0.95 and 0.96 in the derivation and validation cohort. The increasing PIRO score was also associated with mortality (P<.001) in both the derivation and validation cohorts., Conclusions: The PIRO model identifies and stratifies acute on chronic liver failure patients at risk of developing acute kidney injury. It reliably predicts mortality in these patients, underscoring the prognostic significance of acute kidney injury in patients with acute on chronic liver failure., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background and Aim: Once thought to be uncommon in Asia, coeliac disease (CD) is now being increasingly recognized in Asia–Pacific region. In many Asian nations, CD is still considered to be either nonexistent or very rare. In recognition of such heterogeneity of knowledge and awareness, the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology commissioned a working party to address the key issues in emergence of CD in Asia., Methods: A working group consisting of members from Asia–Pacific region, Europe, North America, and South America reviewed relevant existing literature with focus on those issues specific to Asia–Pacific region both in terms of what exists and what needs to be done., Results: The working group identified the gaps in epidemiology, diagnosis, and management of CD in Asian–Pacific region and recommended the following: to establish prevalence of CD across region, increase in awareness about CD among physicians and patients, and recognition of atypical manifestations of CD. The challenges such as variability in performance of serological tests, lack of population-specific cut-offs values for a positive test, need for expert dietitians for proper counseling and supervision of patients, need for gluten-free infrastructure in food supply and creation of patient advocacy organizations were also emphasized., Conclusions: Although absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years or decades. It is thus appropriate that medical community across the Asia–Pacific region define extent of problem and get prepared to handle impending epidemic of CD.

Inflammatory bowel disease (IBD) once considered to be a disease only of the Western world is no longer so. Though good epidemiological studies are available from the West, still the information available from Asia is inadequate. This article is a review of the available epidemiological studies from Asia. The incidence / prevalence rates of IBD are still the highest in Europe and North America, though there is convincing evidence of rising trend of IBD in Asian countries; India probably heads the list. There is a need to study the role of various environmental and genetic factors in different countries in Asia. At present, ulcerative colitis predominates but Crohn's disease is expected to manifest more in coming years.

Vitamin D nutrition in pregnancy was investigated in 115 Asian women living in London, and in 50 of their newborn infants. Mean serum 25-hydroxy cholecalciferal (25-OHD) concentration at the beginning of the last trimester was 20.2 nmol/l, and fell to 16.0 nmol/1 post partum. Thirty-six per cent of the women post partum and 32 per cent of the infants had undetectable 25-OHD concentrations (less than 3 nmol/l). Such low values are commonly associated with osteomalacia and rickets. The bone isoenzyme of alkaline phosphatase was elevated in 20 per cent of the women post partum, and in 50 per cent of the infants, indicating the presence of sub-clinical bone disease. Five infants had symptomatic hypocalcaemia. Vitamin D deficiency was most likely to occur in Pakistanis, Hindu Indians and East African Asians, and in vegetarians. All British Asians should receive supplementary Vitamin D during pregnancy.