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Mammals are the most important elements in Cenozoic terrestrial ecosystem. The composition and the character of a mammalian fauna are controlled by evolution time and evolutionary rate. Here we took 50 Asian Paleogene mammalian faunas as representatives and applied Bayesian Tip-dating method to infer the relationships and divergence times among these faunas. Based on the results of Bayesian Tip-dating analyses, we discussed the correlation between the paleogeographic changes and the mammalian fauna turn-overs. Compared with the traditional fauna correlation and sorting, Bayesian Tip-dating analyses revealed more detailed similarities reflected via the divergence times among the 50 faunas. We discovered that the early Eocene mammalian fauna, which firstly appeared in India subcontinent, is similar to the faunas of the same age in other parts of Asia. It is likely that a passage for the mammalian dispersal was formed before early Eocene. Bayesian inferring suggests that the first appearance of the dispersal passage is during 64.8–61.3 Ma. This time window is close to the time estimation for the initial time of India-Asia collision. During 57.1–47.2 Ma, India subcontinent probably had a habitat different from the main part of Asia, as it was reflected from the composition of the mammalian faunas. It is probably correlated with the uplifted Gangdese Mountain and shallow seas and lowlands on both sides of the collision region. The very remote divergence time (64.8 Ma) estimated by Bayesian inferring reflects the mammalian fauna turnover during the Eocene-Oligocene transition, obviously affected by the global cooling. Till the end of Oligocene, the Arabic Peninsula and Asian mainland remained separated and the mammalian faunas did not show clear connection. [ABSTRACT FROM AUTHOR]

This article theorizes the colonial problem of peoplehood that Indian anticolonial thinkers grappled with in their attempts to conceptualize self-rule, or swaraj. British colonial rule drew its legitimacy from a developmentalist conception of the colonized people as backward and disunited. The discourse of "underdeveloped" colonial peoplehood rendered the Indian people "unfit" for self-government, suspending their sovereignty to an indefinite future. The concept of swaraj would be born with the rejection of deferred colonial self-government. Yet the persistence of the developmentalist figuration of the people generated a crisis of sovereign authorization. The pre-Gandhian swaraj theorists would be faced with the not-yet claimable figure of the people at the very moment of disavowing the British claim to rule. Recovering this underappreciated pre-Gandhian history of the concept of swaraj and reinterpreting its Gandhian moment, this article offers a new reading of Gandhi's theory of moral self-rule. In so doing, it demonstrates how the history of swaraj helps trace the colonial career of popular sovereignty. [ABSTRACT FROM AUTHOR]

What is known and Objective: As a crucial protective role in the detoxifying mechanisms of drugs, glutathione S‐transferases (GSTs) may affect an individual patient's susceptibility to anti‐tuberculosis drug‐induced liver injury (ATLI). However, the results of studies investigate the association between GSTM1, GSTT1 and GSTP1 polymorphisms and risk of ATLI are inconclusive. A meta‐analysis on this topic was performed. Methods: PubMed, EMBASE, ISI web of science and the Chinese National Knowledge Infrastructure (CNKI) were systematically searched to identify relevant studies. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Heterogeneity among articles and publication bias were also tested. Results and discussion: After excluding one study as an outlier, the null GSTM1 genotype was associated with an increased risk of ATLI (OR = 1.270, 95% CI (1.014‐1.590, P = .038), especially in East Asians (OR = 1.501, 95% CI (1.303‐1.730). With similar exclusion, the null GSTT1 genotype increased the risk of ATLI in the total population (OR = 1.169, 95% CI: 1.028‐1.330) and in Indians (OR = 1.732, 95% CI: 1.229‐2.416). No statistically significant association was observed between the mutant GSTP1 genotype with risk of ATLI, which may need more rigorous and uniform case‐control or cohort studies for more robust inferences. What is new and conclusion: This up‐to‐date meta‐analysis strongly suggests associations of GSTM1 and GSTT1 polymorphisms with ATLI. The results show the increased risk of ATL1 with the null GSTM1 and GSTT1 genotype on ATLI development. No such association is shown with the mutant GSTP1 genotype. [ABSTRACT FROM AUTHOR]

Background: Health insurance is the primary mechanism that enables people to obtain health care services. There are three major types of health insurance involves private health insurance, social health insurance and community-based health insurance. Aims: This systematic review aims to identify the implication on equity after implementation of health insurance focusing on selected Asian countries. The review is based on the three dimensions of universal health coverage (UHC): population coverage, and service coverage and financial coverage. Materials and methods: A systematic search for articles was conducted form 4 search engines, Scopus, Science Direct, Proquest, and Google scholar. A total of 13 articles were selected after screenings and equity implications were concluded in three UHC dimensions based on equity index reported or equity improvement observed in time series studied. Result and discussion: All the three health insurance has different implication on equity between countries or within country. In terms of population coverage, SHI in Thailand showed an equitable coverage. Philippine also reported to have equitable population coverage in terms of geographical while in Vietnam, CBHI showed inequitable population coverage. The financial coverage has showed an inequity of CBHI in India, China, and Thailand. The inequity was also observed for SHI in Philippine, Vietnam and Philippines. More apparent is inequity in PHI for Malaysia and Philippines. The only equitable financial coverage reported was Thailand for its SHI. The final aspect is on service delivery coverage with equity has been observed in CBHI in China and SHI in Vietnam and Thailand. Conclusion: Social health insurance schemes can be further improved in addressing equity in all UHC aspects. CBHI of which showed some equitable measures for certain population subgroups, such as the poor, and formal workers can collectively be the way to go for SHI. [ABSTRACT FROM AUTHOR]

Curcumin is widely consumed in Asia either as turmeric directly or as one of the culinary ingredients in food recipes. The benefits of curcumin in different organ systems have been reported extensively in several neurological diseases and cancer. Curcumin has got its global recognition because of its strong antioxidant, anti‐inflammatory, anti‐cancer, and antimicrobial activities. Additionally, it is used in diabetes and arthritis as well as in hepatic, renal, and cardiovascular diseases. Recently, there is growing attention on usage of curcumin to prevent or delay the onset of neurodegenerative diseases. This review summarizes available data from several recent studies on curcumin in various neurological diseases such as Alzheimer's disease, Parkinson's disease, Multiple Sclerosis, Huntington's disease, Prions disease, stroke, Down's syndrome, autism, Amyotrophic lateral sclerosis, anxiety, depression, and aging. Recent advancements toward increasing the therapeutic efficacy of curcuma/curcumin formulation and the novel delivery strategies employed to overcome its minimal bioavailability and toxicity studies have also been discussed. This review also summarizes the ongoing clinical trials on curcumin for different neurodegenerative diseases and patent details of curcuma/curcumin in India. [ABSTRACT FROM AUTHOR]

Western disturbances (WDs) are synoptic-scale cyclonic weather systems advected over Pakistan and northern India by the subtropical westerly jet stream. There, they are responsible for most of the winter precipitation, which is crucial for agriculture of the rabi crop as well for as more extreme precipitation events, which can lead to local flooding and avalanches. Despite their importance, there has not yet been an attempt to objectively determine the fate of WDs in future climate GCMs. Here, a tracking algorithm is used to build up a catalog of WDs in both CMIP5 historical and representative concentration pathway (RCP) experiments of the future. It is shown that in business-as-usual (RCP8.5) future climate simulations, WD frequency falls by around 15% by the end of the twenty-first century, with the largest relative changes coming in pre- and postmonsoon months. Meanwhile, mean WD intensity will decrease, with central vorticity expected to become less cyclonic by about 12% over the same period. Changes in WD frequency are attributed to the projected widening and weakening of the winter subtropical jet as well as decreasing meridional wind shear and midtropospheric baroclinic vorticity tendency, which also explain the changes in intensity. The impact of these changes on regional precipitation is explored. The decline in WD frequency and intensity will cause a decrease in mean winter rainfall over Pakistan and northern India amounting to about 15% of the mean—subject to the ability of the models to represent the responsible processes. The effect on extreme precipitation events, however, remains unclear. [ABSTRACT FROM AUTHOR]

Inequalities between native-born and foreign-born individuals in screening rates for a variety of conditions have been well-documented in literature on immigrant health. A preponderance of this research focuses on the Latin American case and on cancer-specific screening. This study seeks to expand knowledge of such preventative-health screening differences by analyzing screening rates for blood sugar, blood pressure, and serum cholesterol among nine groups overall and (for immigrants) at various stages of US residency. Using nationally representative data from the National Health Interview Survey, we find that immigrants from eight geographic regions receive preventative care at lower rates than US-born Whites and that preventative screening is generally higher after 15 years than during the first 4 years of residency in the United States. Importantly, our data also show that screening patterns and trends vary based on region of origin and outcome. These findings improve our understanding of immigrant health and health care use in the United States. [ABSTRACT FROM AUTHOR]

Introduction: The National Rural Health Mission (NRHM) was launched in India in 2005 to address the health needs of under-served populations in rural areas, and to support universal access to care. Despite this initiative, unaccredited informal providers (IPs) often remain patients’ first point of contact, which has led to inconsistencies in treatment, and has compromised the quality of care. Aim: To explore the factors that influence patients’ decisions about healthcare providers in rural areas of central India. Methods: Nine focus group discussions (FGDs) were held in nine villages in central India. Framework analysis using an inductive approach was used to analyse the data. Results: The crosscutting theme across the discussions was not choice but need—the need for affordable and accessible health care regardless of the provider’s qualification. Results highlighted that IPs play a pivotal role in villagers’ lives. Formal healthcare services were accessed infrequently, and mainly when a condition was judged severe or possibly even fatal. Even then, affordability was carefully weighed. Villagers’ distance from formal providers contributed to high cost and low preference of formal providers. When opting for IPs, familiarity and trust were more important to villagers than qualifications. IPs have operated in rural communities in India for a long time and have adapted their services to meet the needs, preferences, social norms, and economic conditions of villagers. Conclusion: IPs have captured a niche and are often the first contact point in rural settings even when patients ultimately are diagnosed and treated by trained doctors. Merely tackling the undersupply of qualified doctors is not effective or sufficient to impact on the rural healthcare system: the strong and prevalent influence of IPs needs to be addressed also. [ABSTRACT FROM AUTHOR]

India fell behind during colonial rule. The absolute and relative decline of Indian GDP per capita with respect to Britain began before colonization and coincided with the rise of the textile trade with Europe. However, the fortunes of the traditional textile industry cannot explain the decline in the eighteenth century and stagnation in the nineteenth century as India integrated into the global economy of the British Empire. Inadequate investment in agriculture and consequent decline in yield per acre stalled economic growth. Modern industries emerged and grew relatively fast. The reversal began after independence. Policies of industrialization and a green revolution in agriculture increased productivity in agriculture and industry. However, India's growth in the closing decades of the twentieth century has been led by services. A concentration of human capital in the service sector has origins in colonial policy. Expenditure on education prioritized higher education, creating an advantage for the service sector. At the same time, the slow expansion of primary education lowered the accumulation of human capital and put India at a disadvantage in comparison with the fast‐growing economies of East Asia. [ABSTRACT FROM AUTHOR]

Background: Although most Indians live in rural settings, data on cardiovascular disease risk factors in these groups are limited. We describe the association between socioeconomic position and cardiovascular disease risk factors in a large rural population in north India. Methods: We performed representative, community-based sampling from 2013 to 2014 of Solan district in Himachal Pradesh. We used education, occupation, household income, and household assets as indicators of socioeconomic position. We used tobacco use, alcohol use, low physical activity, obesity, hypertension, and diabetes as risk factors for cardiovascular disease. We performed hierarchical multivariable logistic regression, adjusting for age, sex and clustering of the health sub-centers, to evaluate the cross-sectional association of socioeconomic position indicators and cardiovascular disease risk factors. Results: Among 38,457 participants, mean (SD) age was 42.7 (15.9) years, and 57% were women. The odds of tobacco use was lowest in participants with graduate school and above education (adjusted OR 0.11, 95% CI 0.09, 0.13), household income >15,000 INR (adjusted OR 0.35, 95% CI 0.29, 0.43), and highest quartile of assets (adjusted OR 0.28, 95% CI 0.24, 0.34) compared with other groups but not occupation (skilled worker adjusted OR 0.93, 95% CI 0.74, 1.16). Alcohol use was lower among individuals in the higher quartile of income (adjusted OR 0.75, 95% CI 0.64, 0.88) and assets (adjusted OR 0.70, 95% CI 0.59, 0.82). The odds of obesity was highest in participants with graduate school and above education (adjusted OR 2.33, 95% CI 1.85, 2.94), household income > 15,000 Indian rupees (adjusted OR 1.89, 95% CI 1.63, 2.19), and highest quartile of household assets (adjusted OR 2.87, 95% CI 2.39, 3.45). The odds of prevalent hypertension and diabetes were also generally higher among individuals with higher socioeconomic position. Conclusions: Individuals with lower socioeconomic position in Himachal Pradesh were more likely to have abnormal behavioral risk factors, and individuals with higher socioeconomic position were more likely to have abnormal clinical risk factors. [ABSTRACT FROM AUTHOR]

The sex ratio at birth (SRB; ratio of male to female live births) imbalance in parts of the world over the past few decades is a direct consequence of sex-selective abortion, driven by the coexistence of son preference, readily available technology of prenatal sex determination, and fertility decline. Estimation of the degree of SRB imbalance is complicated because of unknown SRB reference levels and because of the uncertainty associated with SRB observations. There are needs for reproducible methods to construct SRB estimates with uncertainty, and to assess SRB inflation due to sex-selective abortion. We compile an extensive database from vital registration systems, censuses and surveys with 10,835 observations, and 16,602 country-years of information from 202 countries. We develop Bayesian methods for SRB estimation for all countries from 1950 to 2017. We model the SRB regional and national reference levels, the fluctuation around national reference levels, and the inflation. The estimated regional reference levels range from 1.031 (95% uncertainty interval [1.027; 1.036]) in sub-Saharan Africa to 1.063 [1.055; 1.072] in southeastern Asia, 1.063 [1.054; 1.072] in eastern Asia, and 1.067 [1.058; 1.077] in Oceania. We identify 12 countries with strong statistical evidence of SRB imbalance during 1970-2017, resulting in 45.0 [36.4; 54.8] million missing female births globally. The majority of those missing female births are in China, with 23.1 [16.5; 30.7] million, and in India, with 20.7 [15.5; 26.6] million. [ABSTRACT FROM AUTHOR]

Background: Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. Materials and methods: We conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner. Results: Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another. Conclusions: A holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts. [ABSTRACT FROM AUTHOR]

Despite the efforts of community health workers to increase access to healthcare among ethnic minority groups in low- and -middle income countries, members of ethnic minorities are less likely than women from other ethnic groups to use maternal and child healthcare services. However, much less is known about the factors that limit access of ethnic minorities to healthcare services, including the services of community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different geographical locations (the hill and Terai regions- flatland bordering south India) with varying degrees of access to local healthcare centres. Between April 2014 and September 2014, semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions. A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups such as Dalits, Madhesi, Muslim, Chepang and Tamang. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres. We conclude that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including multiple forms of malnutrition (MOM), public health nutrition (PHN), micronutrient deficiencies, exclusive breastfeeding (EBF), and gestational diabetes mellitus (GDM).

The clinopyroxene amphibolite from the Bailang terrane is located in the central section of the Yarlung Zangbo suture zone (YZSZ), southern Tibet. The study of it is expected to provide important clues for the subduction of the Neo-Tethyan Ocean below the Asian Plate and thus for better understanding of the development of the India-Asia collision zone. Based on integrated textural, mineral compositional, metamorphic reaction history and geothermobarometric studies of the clinopyroxene amphibolite within a serpentinite mélange, four overprinted metamorphic stages are established. They are the first metamorphic record of M1 stage indicated by a relict assemblage of plagioclase+clinopyroxene+amphibole, an early M2 stage characterized by an assemblage of medium-grained clinopyroxene+amphibole+plagioclase+quartz as well as rutile inclusion in titanite, which is formed during burial process, an isobaric cooling M3 stage which is characterized by an assemblage of clinopyroxene+amphibole+plagioclase+titanite, and a decomposing retrograde stage M4, which is represented by the amphibolite+plagioclase symplectite+titanite+ rutile+quartz. By applying the THERMOCALC (versions 6.2 and 6.3) technique in the NCFMASHTO system, the P-T conditions estimated from M1 to M4 stages are ca. 8.6 kbar/880 °C, 10.8-13.4 kbar/800-840 °C, 12.7-13.2 kbar/650-660 °C and <11.2 kbar/640 °C, respectively. The mineral assemblages and their P-T conditions define a counterclockwise P-T path for the clinopyroxene amphibolite of the Xigaze ophiolite, suggesting that the rocks underwent a cooling process during burial from magmatic protolith, and a decompressing stage after the pressure peak metamorphic conditions, which implies that the Bailang terrane of the Xigaze ophiolite may have experienced subduction/collision-related tectonic processes. The peak metamorphism reaches to the transitional P-T conditions among amphibolite facies, granulite facies and eclogite facies with a burial depth of 30–40 km. After exhumation of the ophiolitic unit to the shallow crustal levels, the clinopyroxene amphibolite exposes to a high fO2 condition on the basis of the stable epidotebearing assemblage in the T-MO2 diagrams. A late subgreenschist facies overprinting subsequently occurs, the relevant mineral assemblage is prehnite+albite+chlorite+epidote+quartz. [ABSTRACT FROM AUTHOR]

The paper examines trends and issues in digital education programmes globally, drawing examples of developmental growth of Library Information Science (LIS), schools and digital education courses in North America, Britain, and Southern Asia, the slow growth of LIS schools and digital education in Nigeria and some countries in Africa and India. The literature so far visited dictated problems of inadequacy in digital education globally to dearth of faculty, training facilities, no collaboration among LIS schools in developing countries, encouraging collaborations in developed countries and not many students attracted to the course. Recommended solutions are suggested for attracting students into the programme and what to do to make it competitive like other programmes in the universities.

Introduction: Abortion is legal in India and medication abortion (MA) using a combined regimen of mifepristone and misoprostol is the preferred method. Users increasingly purchase MA kits directly from pharmacies, in some cases experiencing perceived complications and approaching a facility for care. We present findings of a qualitative research tracing the decision-making pathway(s) of MA users in Uttar Pradesh, India, to help understand knowledge and behaviour gaps, and recommend ways to improve the overall quality of care at these service delivery points. Methods: Forty in-depth interviews were conducted with recent MA users (20 each of clinic and pharmacy clients) across three districts. Providers were purposively selected in collaboration with an international organization selling MA kits, using their list of pharmacies and clinics. MA users were identified from the clients of the selected providers, and additionally through the snow ball method. Interviews were conducted in Hindi with verbal informed consent in a private place convenient to the respondent. Transcripts were translated to English and analysed thematically. Results: Users first sought MA kits at pharmacies out of convenience, low cost and customer anonymity. Men often purchased kits for their partners and trusted the chemist for guidance on dosage, progression and side effects. For side effects or other concerns after using an MA kit, users first visited their neighbourhood doctor or traditional practitioner. These providers either attempted to treat the issue and failed, or directly advised her to consult a gynaecologist. The final point of care was gynaecologists, preferably female private practitioners with their own clinics. They diagnosed most abortion-related cases as incomplete abortions, emptying the uterus using the dilation and curettage method. Comparatively low cost and convenience made users inclined towards repeat use of MA. Conclusion: There are information gaps at various stages in the MA pathway that need to be addressed. Large scale public information programmes are required on safe abortion care- when is it legal, where to obtain MA, dosage, side effects and signs of possible complications. Pharmacists could be trained or incentivized to improve their quality of care to facilitate adequate exchange of information on MA. Since, for most couples, the male partner purchases MA, information approaches or tools are needed that pharmacists can give men to share directly with the MA user. [ABSTRACT FROM AUTHOR]

We have performed backward trajectory calculations and simulations with the three-dimensional Chemical Lagrangian Model of the Stratosphere (CLaMS) for two succeeding monsoon seasons using artificial tracers of air mass origin. With these tracers we trace back the origin of young air masses (age <6 months) at the top of the Asian monsoon anticyclone and of air masses within the tropical pipe (6 months < age <18 months) during summer 2008. The occurrence of young air masses (<6 months) at the top of the Asian monsoon anticyclone up to ∼460 K is in agreement with satellite measurements of chlorodifluoromethane (HCFC-22) by the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) instrument. HCFC-22 can be considered as a regional tracer for continental eastern Asia and the Middle East as it is mainly emitted in this region. Our findings show that the transport of air masses from boundary layer sources in the region of the Asian monsoon into the tropical pipe occurs in three distinct steps. First, very fast uplift in "a convective range" transports air masses up to 360 K potential temperature within a few days. Second, air masses are uplifted from about 360 K up to 460 K within "an upward spiralling range" within a few months. The large-scale upward spiral extends from northern Africa to the western Pacific. The air masses are transported upwards by diabatic heating with a rate of up to 1–1.5 K per day, implying strong vertical transport above the Asian monsoon anticyclone. Third, transport of air masses occurs within the tropical pipe up to 550 K associated with the large-scale Brewer–Dobson circulation within ∼1 year. In the upward spiralling range, air masses are uplifted by diabatic heating across the (lapse rate) tropopause, which does not act as a transport barrier, in contrast to the extratropical tropopause. Further, in the upward spiralling range air masses from inside the Asian monsoon anticyclone are mixed with air masses convectively uplifted outside the core of the Asian monsoon anticyclone in the tropical adjacent regions. Moreover, the vertical transport of air masses from the Asian monsoon anticyclone into the tropical pipe is weak in terms of transported air masses compared to the transport from the monsoon anticyclone into the northern extratropical lower stratosphere. Air masses from the Asian monsoon anticyclone (India/China) contribute a minor fraction to the composition of air within the tropical pipe at 550 K (6 %), and the major fractions are from Southeast Asia (16 %) and the tropical Pacific (15 %). [ABSTRACT FROM AUTHOR]

The Upper Triassic Langjiexue Group in southeastern Tibet has long been an enigmatic geological unit. It belongs tectonically to the northern Tethys Himalayan zone, but provenance signatures of the detritus it contains are significantly different from those of typical Tethys Himalayan sandstones. Because the Langjiexue Group is everywhere in fault contact with Tethys Himalayan strata, its original paleogeographic position has remained controversial for a long time. According to some researchers, the Langjiexue Group was deposited onto the northern edge of the Indian passive continental margin, whereas others interpreted it as an independent block accreted to the northern Indian margin only during final India-Asia convergence and collision in the Paleocene. This study compares the Langjiexue Group and coeval Upper Triassic strata of the southern Tethys Himalayan zone (Qulonggongba Formation). Our new provenance data indicate that Qulonggongba Formation sandstones contain common felsic volcanic rock fragments, minor plagioclase, and euhedral to subhedral zircon grains yielding Late Paleozoic to Triassic ages. These provenance features compare well with those of the Langjiexue Group. Because the Qulonggongba Formation certainly belongs to the Tethys Himalayan zone, the provenance similarity with the Langjiexue Group indicates that the latter is also an in situ Tethys Himalayan sedimentary sequence rather than part of an exotic block. Volcanic detritus including Late Paleozoic to Triassic zircon grains in both Langjiexue Group and Qulonggongba Formation are interpreted to have been derived from the distant Gondwanide orogen generated by Pan-Pacific subduction beneath the southeastern margin of Gondwana. The Qulonggongba Formation, deposited above marlstones of the lower Upper Triassic Tulong Group, is overlain by India-derived coastal quartzose sandstones of the uppermost Triassic Derirong Formation. Deposition of both the Qulonggongba Formation and the Langjiexue Group were most likely controlled by regional tectonism, possibly a rifting event along the northern margin of Gondwana. [ABSTRACT FROM AUTHOR]

Objective: Exacerbations are important outcomes in asthma. Risk factors for exacerbations may differ in different populations. Although various demographic and clinical variables were examined in previous studies on exacerbation risks in asthma, important variables such as ethnicity, adherence, and medication titration were not included. This study examined independent predictors of future exacerbations in a multi-ethnic asthma population in Asia, while including the variables of ethnicity, medication adherence, and medication change in our analysis. Methods: We recruited patients with physician-diagnosed asthma in a tertiary hospital in Singapore over a one-year period. Exacerbations requiring ≥3 days of systemic corticosteroids one year prior to study enrolment (previous exacerbations) and the year following enrolment (future exacerbations) were recorded from electronic medical records. Medication adherence was based on pharmacy refill. An increase or a decrease in the Global Initiative for Asthma treatment steps were considered to be medication up- and down-titration, respectively. A multivariate logistic regression model was constructed to determine independent predictors of future exacerbations. Results: The study cohort of 340 patients comprised mainly of Chinese (53.2%), Malay (32.9%), and Indian (9.7%) ethnicities. After multivariate analysis, only Indian ethnicity (OR 3.75, 95% CI 1.077–13.051, p = 0.038), Asthma Control Test score (OR 0.913, 95% CI 0.839–0.995, p = 0.037), and the number of previous exacerbations (OR 1.84, 95% CI 1.416–2.391, p < 0.001) were independent predictors of future exacerbations. Conclusions: There are ethnic differences in exacerbation risk in Asian populations. Each incremental worsening of the asthma symptom control score and each additional exacerbation also increases the risk of future exacerbations. [ABSTRACT FROM AUTHOR]

In this work we couple the HTAP_v2.2 global air pollutant emission inventory with the global source receptor model TM5-FASST to evaluate the relative contributions of the major anthropogenic emission sources (power generation, industry, ground transport, residential, agriculture and international shipping) to air quality and human health in 2010. We focus on particulate matter (PM) concentrations because of the relative importance of PM 2.5 emissions in populated areas and the well-documented cumulative negative effects on human health. We estimate that in 2010, depending on the region, annual averaged anthropogenic PM 2.5 concentrations varied between ca. 1 and 40 µ g m -3 , with the highest concentrations observed in China and India, and lower concentrations in Europe and North America. The relative contribution of anthropogenic emission sources to PM 2.5 concentrations varies between the regions. European PM pollution is mainly influenced by the agricultural and residential sectors, while the major contributing sectors to PM pollution in Asia and the emerging economies are the power generation, industrial and residential sectors. We also evaluate the emission sectors and emission regions in which pollution reduction measures would lead to the largest improvement on the overall air quality. We show that air quality improvements would require regional policies, in addition to local- and urban-scale measures, due to the transboundary features of PM pollution. We investigate emission inventory uncertainties and their propagation to PM 2.5 concentrations, in order to identify the most effective strategies to be implemented at sector and regional level to improve emission inventories, knowledge and air quality modelling. We show that the uncertainty of PM concentrations depends not only on the uncertainty of local emission inventories, but also on that of the surrounding regions. Countries with high emission uncertainties are often impacted by the uncertainty of pollution coming from surrounding regions, highlighting the need for effective efforts in improving emissions not only within a region but also from extra-regional sources. Finally, we propagate emission inventory uncertainty to PM concentrations and health impacts. We estimate 2.1 million premature deaths per year with an uncertainty of more than 1 million premature deaths per year due to the uncertainty associated only with the emissions. [ABSTRACT FROM AUTHOR]

Background: Outreach and promotion programs are essential to ensuring uptake of new public health interventions and guidelines. We assessed the costs and operation dynamics of outreach and promotion efforts for up front Xpert MTB/RIF (Xpert) testing for pediatric presumptive tuberculosis (TB) patients in four major Indian cities. Methods: Xpert test costs were assessed as weighted average per-test costs based on the daily workload dynamics matched by test volume specific Xpert unit cost at each study site. Costs of outreach programs to recruit health providers to refer pediatric patients for Xpert testing were assessed as cost per referral for each quarter based on total program costs and referral data. All costs were assessed in the health service provider’s perspective and expressed in 2015 USD. Results: Weighted average per-test costs ranged from $14.71 to $17.81 at the four laboratories assessed. Differences between laboratories were associated with unused testing capacity and/or frequencies of overtime work to cope with increasing demand and same-day testing requirements. Outreach activities generated between 825 and 2,065 Xpert testing referrals on average each quarter across the four study sites, translating into $0.63 to $2.55 per patient referred. Overall outreach costs per referral decreased with time, stabilizing at an average cost of $1.10, and demonstrated a clear association with increased referrals. Conclusions: Xpert test and outreach program costs within and across study sites were mainly driven by the dynamics of Xpert testing demand resulting from the combined outreach activities. However, these increases in demand required considerable overtime work resulting in additional costs and operational challenges at the study laboratories. Therefore, careful laboratory operational adjustment should be evaluated at target areas in parallel to the anticipated demand from the Xpert referral outreach program scale-up in other Indian regions. [ABSTRACT FROM AUTHOR]

Agricultural irrigation has significant potential for altering local climate by reducing soil albedo, increasing evapotranspiration, and enabling greater leaf area. Numerous studies using regional or global climate models have demonstrated the cooling effects of irrigation on mean and extreme temperature, especially over regions where irrigation is extensive. However, these model‐based results have not been well validated due to the limitations of observational data sets. In this study, multiple satellite‐based products, including the Moderate Resolution Imaging Spectroradiometer (MODIS) and Soil Moisture Active Passive (SMAP) data sets, are used to isolate and quantify the local impacts of irrigation on surface climate over irrigated regions, which are derived from the Global Map of Irrigation Areas (GMIA). The relationships among soil moisture, albedo, evapotranspiration, and surface temperature are explored. Strong evaporative cooling by irrigation lowers daytime surface temperature over arid and semi‐arid regions, such as California's Central Valley, the Great Plains, central Asia, and northwestern India. However, the cooling effects are less evident in areas of eastern China and the Lower Mississippi River Basin despite extensive irrigation over these regions. Results are also compared with irrigation experiments using the Community Earth System Model (CESM) to assess the model's ability to represent land–atmosphere interactions in regards to irrigation. CESM greatly underestimates the surface temperature response to irrigation. The comparison between the offline and coupled simulations suggests that the irrigation‐induced cooling can be regulated by the interactions between land surface and atmosphere, and amplified signals are found over the "hot spot" regions. Meanwhile, model resolution can also influence the magnitude of the local cooling by irrigation. This study, for the first time, thoroughly investigated the observed local impacts of irrigation on surface climate based on multiple satellite‐based products at the global scale. Strong evaporative cooling of irrigation on daytime surface temperature is found over arid and semi‐arid regions, such as California's Central Valley, the Great Plains, central Asia, and northwestern India. However, the cooling effects are less evident in areas of eastern China and the Lower Mississippi River Basin despite extensive irrigation over these regions. [ABSTRACT FROM AUTHOR]

Based on more recent science spending developments in countries such as China, Korea, India and Brazil, there is a growing sense that the world’s scientific deck of cards is in the midst of a major reshuffle. But it is not clear if this reordering is limited to just the top spenders, or, indeed, how these changes have been playing out over the longer term. The new, more comprehensive research and development (R&D) spending estimates presented and discussed here reveal that we are in the midst of a possibly game-changing, albeit partial and perhaps irregular, reshuffle of the global R&D deck. These changes have potentially profound domestic and international economic development implications over the medium to long term. Notably, the fortunes of many of the world’s poorer countries continue to look bleak. Using the evolving structure of past R&D spending to project forward, and absent marked changes in science policies and spending priorities, we foresee a continuing and substantial shift in the geography of R&D towards parts of Asia, along with a continuing large, and in many respects growing, gap between the world’s scientific haves and have-nots. [ABSTRACT FROM AUTHOR]

Commercial surrogacy in emerging countries such as India is often associated with exploitation of vulnerable women, the assumption being that it is performed by poor and uneducated women for rich intended parents. However, the hypothesis that surrogates are poor women has rarely been confronted with field data. The objective was to compare the socioeconomic characteristics of Indian surrogates interviewed in social studies with those of Indian women in the general population in order to provide preliminary data on whether surrogates have a specific profile and are indeed disadvantaged compared with their counterparts. The study analyzes the data from four cross-sectional studies carried out in India among surrogates between 2006 and 2014. Surrogates were recruited through clinics, agencies and agents. Data were collected during face-to-face interviews. The resulting convenience sample included 96 Indian surrogates. Their sociodemographic characteristics were compared with those of the general population extracted from Indian national surveys. The surrogates interviewed had their first child at a younger age than women in the general population, but they tended to have a smaller family. Their social situation tended to be better than that of the general population in terms of education, employment and family income. These results provide first empirical evidence moderating the common assumption that Indian surrogates are the poorest and least educated women. This does not mean, however, that exploitation does not exist. More studies are needed to confirm these results and to explore the issue in new international destinations for surrogacy. [ABSTRACT FROM AUTHOR]

Recognizing that enteric fever disproportionately affects the poorest and the most vulnerable communities that have limited access to improved sanitation, safe water sources, and optimal medical care, the Bill & Melinda Gates Foundation has funded efforts to augment global understanding of the disease since the foundation's inception. At the turn of the century, early efforts focused on characterizing the burden of disease in Asia and evaluating use of the available Vi-polysaccharide vaccines through the Diseases of the Most Impoverished projects at the International Vaccine Institute (IVI). More recent efforts have centered on supporting development of typhoid conjugate vaccines and expanding disease surveillance efforts into Africa, as well as generating a greater understanding of the clinical severity and sequelae of enteric fever in Africa, Asia, and India. The Typhoid Vaccine Accelerator Consortium is playing a critical role in coordinating these and other global efforts for the control of typhoid fever. Here, we outline the scope of support and strategic view of the foundation and describe how, by working through strong partnerships, we can realize a radical reduction of the significance of enteric fever as a global public health problem in the next 10 to 15 years. [ABSTRACT FROM AUTHOR]

Aims This study aims to measure the prevalence rates and patterns of help-seeking behavior as a consequence of being harmed by drinkers in five Asian countries (India, Sri Lanka, Vietnam, Lao PDR and Thailand). Methods A total of 9832 respondents aged 18–65 years from the WHO/ThaiHealth Collaborative Project were surveyed between 2012 and 2014 about their experiences of being negatively affected due to another's drinking, and whether and where they sought help, focusing on four adverse aspects of harms from others' drinking. Results The prevalence of seeking help from any source in the past year due to harm from others' drinking ranged from 7% to 20%. The most common service used by those who were affected by other people's drinking was asking for help from friends, followed by calling the police and using health-related services. The largest proportion of help-seeking was among those reporting property harm, followed by those being harmed physically and sexually by drinkers. Conclusion Given a wide range of harms from others' drinking in the general population and different needs of those affected, prevalence rates for help-seeking behavior due to others' drinking in South and South East Asian countries were low and the help sought was often informal. There is a large knowledge gap in our understanding of the mechanisms of help-seeking behavior and the pathways for access to help among those affected. Further studies are important for enhancing the social response services available and making these more accessible to those who need help. [ABSTRACT FROM AUTHOR]

Background: Evidence supports the integration of prevention and management for tuberculosis (TB) with non-communicable diseases (NCDs). Bi-directional screening for TB and diabetes mellitus (DM) is already implemented in India, a country with a dual burden of TB and NCDs. However, very limited programmatic data are available on the feasibility of adding other NCDs and their risk factors in such screening programme. Objective: To assess the yield, feasibility, and acceptability of a two-stage integrated screening for NCDs and risk factors for NCDs among patients with TB ≥20 years and treated in DOTS centres of two medical colleges in Delhi, between October 2016 and March 2017. Methods: It was a mixed-methods, triangulation study with a quantitative component (cross-sectional study using questionnaires, anthropometric measurements and records review) and a qualitative component (descriptive study using interview data). Results: Amongst 403 patients screened, the prevalence of hypertension was 7% (n = 28) with 20 new cases detected and 8% for DM (n = 32) with 6 new cases diagnosed. The number needed to screen to find a new case was 20 and 63 for hypertension and DM respectively. The most frequent NCD-risk factors were inadequate vegetable (80%) and fruits (72%) intake, alcohol use (34%), use of smokeless tobacco (33%) and smoking (32%). Clustering of four or more risk factors was associated with increasing age and male sex (p<0.05). Both patients and health providers considered the screening relevant and acceptable. However, waiting time and costs involved in blood tests were considered as bothersome by the patients, while health providers perceived increased workload, inadequate medical supplies and inadequate skills and knowledge as key challenges in implementation of the screening. Conclusion: Integrating screening for NCDs and their risk factors in the existing TB programme produces high yield and it is feasible and acceptable by patients and health providers provided the challenges are overcome. [ABSTRACT FROM AUTHOR]

This article explores the North America-dominated YMCA as an influential agent promoting ‘rural reconstruction’ schemes on the Indian subcontinent from the 1920s to the 1950s. During that period, religiously inclined civil society actors from the United States played a crucial role in shaping reform programmes designed to improve South Asian agriculture and educate the ‘backward’ village population. It sheds light on the global history of ‘sustainable village development’ programmes by reconstructing the emergence of a specific new body of development knowledge that was ostentatiously ‘low modernist’ — that is simple, cheap and easily reproducible — and thus deemed ideally suited for the uneducated and impoverished peasants of the global South. The new method was forged in South Asia through the mingling of American ‘scientific’ agricultural expertise and a protestant missionary impulse to morally ‘uplift’ the subcontinental villager with various strands of ‘colonial’, local and global knowledge. This ‘pidginised’ template enjoyed a worldwide circulation from the late 1930s onwards and informed the emerging transnational development regime that would flourish later during the early Cold War era. [ABSTRACT FROM AUTHOR]

This paper presents a study of 428 youths who participated in service-learning projects in developing countries in South-East Asia, China and India. Using mixed-method approach, this study examined the reasons for their participation in the YEP (youth expedition projects) and the impact of their service-learning experiences on their civic attitudes and competence skills. Positive outcomes in civic engagement, competence skills and development of sense of self for participants as a whole and in terms of age group are discussed. The author concludes that it is important to make service-learning an explicit training and educational goal in order for educators to facilitate the building of capacities in youths, so that they can appreciate the value that service-learning can bring in character development and shape early commitment to civic involvement. (Contains 5 tables.)

Objective: Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in India.Design: Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' and derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).Results: From 45 712 abstracts screened, sixty-four cross-sectional, seven cohort, one qualitative and one case-control studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF practices were found in all studies. In twenty-nine of fifty-nine studies, CF was introduced between 6 and 9 months, with eight studies finding minimum dietary diversity was achieved in 6-33 %, and ten of seventeen studies noting minimum meal frequency in only 25-50 % of the study populations. Influencing factors included cultural influences, poor knowledge on appropriate CF practices and parental educational status.Conclusions: This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children. [ABSTRACT FROM AUTHOR]

Background Most stroke research is conducted in high income countries, yet most stroke occurs in low- and middle-income countries. There is an urgent need to build stroke research capacity in low- and middle-income countries. Aims To review the global health literature on how to improve research capacity in low- and middle-income countries, provide additional data from the recently completed ATTEND Trial and provide examples from our own experience. Summary of review The main themes from our literature review were: manpower and workload, research training, research question and methodology and research funding. The literature and our own experience emphasized the importance of local stakeholders to ensure that the research was appropriate, that there were robust local ethics and regulatory processes, and research was conducted by trained personnel. Research training opportunities can be developed locally, or internationally, with many international schemes available to help support new researchers from low- and middle-income country settings. International collaboration can successfully leverage funding from high income countries that not only generate data for the local country, but also provide new data appropriate to high income countries. Conclusions Building stroke research capacity in low- and middle-income countries will be vital in improving global health given the huge burden of stroke in these countries. [ABSTRACT FROM AUTHOR]

Background: Local people in the Himalayan region use a wide range of wild and non-cultivated edible plants (WNEPs) for food, spice, medicinal, and cultural purposes. However, their availability, use, status and contribution to livelihood security are poorly documented, and they have been generally overlooked in recent agro-biodiversity conservation and management programmes. The study aimed to investigate WNEP diversity and current status in a part of the Kailash Sacred Landscape--a transboundary landscape shared by Nepal, India and PR China--in terms of collection, use, management and conservation initiatives. Methods: Multiple methodologies and tools were used for data collection. A series of participatory tools (45 key informant interviews, 10 focus group discussions, a crop diversity fair, direct observation of species through a transect walk and rapid market assessments) was followed by a household survey (195 respondents) and complemented by a literature review. Results: The study recorded 99 WNEPs belonging to 59 families of which 96 were angiosperms, one gymnosperm and two pteridophytes. Species were used for food, spice, medicine, rituals and income generation. Thirty-five species had multiple uses, including these: 40 species were used for fruit and 31 for vegetables. WNEPs contribute significantly to daily food requirements, especially the vegetables. The use value of Dryopteris cochleata was found highest (0.98) among frequently used vegetable species. The values of informant consensus factor were found maximum for worms in the stomach (0.99) and minimum for skin disease treatment (0.67). Nearly 85% of households depended exclusively on WNEPs for at least more than a month per year. Results on the importance and use of different species, gender roles in WNEP activities and conservation approaches are presented. Conclusions: People living in the Kailash Sacred Landscape depend significantly on WNEPs, and this is especially critical in times of food shortage. The WNEPs have considerable potential as an important supplement to cultivated food crops. Farmers prioritise species with multiple use values and popular vegetables. However, there are numerous challenges and interventions needed to ensure conservation and management of species and their continued availability to support food security and local livelihoods. [ABSTRACT FROM AUTHOR]

Despite substantial progress in social development during the post-colonial period, health inequalities in the South Asian countries were staggering, with reduced life expectancy, higher maternal and child mortality, and gender discrimination. Notably, even with the rapid economic growth during the neoliberal period, India fares below most of the South Asian countries in several health indicators. The Indian state of Kerala stands out with social sector gains; nevertheless, evidence indicates widening health inequalities, restricted public arenas, and undemocratic practices in health, particularly in the context of increasing market logic in the health and social arenas shaping health. The caste, class, gender, and ethnic ideologies and patriarchal power structure interwoven in the sociopolitical, cultural, moral, and health discourses similar to the South Asian context raise serious inequalities for health. At the launch of the United Nations' Sustainable Development Goals, the populations with lingering privations and forbidden freedoms for gaining better health in Kerala, similar to South Asia, were largely the dalits, ethnic and religious minorities, and women. This necessitates greater political interventions, recognizing the interacting effects of history, culture, social factors, politics, and policies on health. And public health research needs to underscore this approach. [ABSTRACT FROM AUTHOR]

Background: The use of early morning sputum samples (EMS) to diagnose tuberculosis (TB) can result in treatment delay given the need for the patient to return to the clinic with the EMS, increasing the chance of patients being lost during their diagnostic workup. However, there is little evidence to support the superiority of EMS over spot sputum samples. In this new analysis of the REMoxTB study, we compare the diagnostic accuracy of EMS with spot samples for identifying Mycobacterium tuberculosis pre- and post-treatment.Methods: Patients who were smear positive at screening were enrolled into the study. Paired sputum samples (one EMS and one spot) were collected at each trial visit pre- and post-treatment. Microscopy and culture on solid LJ and liquid MGIT media were performed on all samples; those missing corresponding paired results were excluded from the analyses.Results: Data from 1115 pre- and 2995 post-treatment paired samples from 1931 patients enrolled in the REMoxTB study were analysed. Patients were recruited from South Africa (47%), East Africa (21%), India (20%), Asia (11%), and North America (1%); 70% were male, median age 31 years (IQR 24-41), 139 (7%) co-infected with HIV with a median CD4 cell count of 399 cells/μL (IQR 318-535). Pre-treatment spot samples had a higher yield of positive Ziehl-Neelsen smears (98% vs. 97%, P = 0.02) and LJ cultures (87% vs. 82%, P = 0.006) than EMS, but there was no difference for positivity by MGIT (93% vs. 95%, P = 0.18). Contaminated and false-positive MGIT were found more often with EMS rather than spot samples. Surprisingly, pre-treatment EMS had a higher smear grading and shorter time-to-positivity, by 1 day, than spot samples in MGIT culture (4.5 vs. 5.5 days, P < 0.001). There were no differences in time to positivity in pre-treatment LJ culture, or in post-treatment MGIT or LJ cultures. Comparing EMS and spot samples in those with unfavourable outcomes, there were no differences in smear or culture results, and positive results were not detected earlier in Kaplan-Meier analyses in either EMS or spot samples.Conclusions: Our data do not support the hypothesis that EMS samples are superior to spot sputum samples in a clinical trial of patients with smear positive pulmonary TB. Observed small differences in mycobacterial burden are of uncertain significance and EMS samples do not detect post-treatment positives any sooner than spot samples. [ABSTRACT FROM AUTHOR]