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Networked computers can potentially support classrooms to be more interactive. It can help students share representations amongst themselves and work together on a shared virtual activity space. In research on the role of shared screens or shared virtual workspace in learning settings, there has been less attention paid to contexts where learners are co-located. This paper looks at the impact of the shared screen in a computational game environment on mathematics learning and practices and the construction of learners' emotions and social status in classroom interactions. We designed two versions of a simple arithmetic game: a solo version in which the student played the game alone and a multi-player version in which the screen was shared, and the players could see the arithmetic moves of the other players. We implemented these two versions of the game in a 4th-grade classroom in a suburban school in a large metropolis in India. Classroom sessions were video recorded, computer logs were collected, and field notes were taken. Focus group sessions were held with the students. We coded a portion of the data to get at patterns of classroom interactions. Then we drew on qualitative video analysis tools to analyze specific episodes to understand the fine timescale dynamics of dominant interaction patterns in each setting. Our analysis shows that the shared screen served as a shared memory device, keeping a record of all the students' posts, and was entangled in the moment-to-moment dynamics of self- and peer- assessments of arithmetic. These findings suggest that thoughtful integration of networked digital tools in computer-supported learning environments can increase student-student interactions and support disciplinary learning.

Melioidosis is a potentially fatal infectious disease that requires an extended period of treatment for complete resolution of the infection. It can lead to chronic and severe infections, and it is more common in diabetic patients. Melioidosis is also a significant concern in India primarily because its chronic nature, potential for dissemination, extended treatment requirements, and the risk of relapse lead to its resemblance to tuberculosis. This case series included osteomyelitis patient presented in emergency with sepsis MODS, disseminated melioidosis patient with systemic involvement including spleen, kidney and lungs, skin abscess at more than one site, urosepsis, splenic abscess, Melioidotic arthritis. Many of these patients had altered blood sugar levels, and in 3 cases, individuals were even diagnosed with diabetes during their episode of melioidosis the treatment duration generally involved an 8-week course of intravenous antibiotics. However, oral medications may need to be continued for several months if necessary for complete recovery. [ABSTRACT FROM AUTHOR]

Objective Indian hospitals (especially government-run public sector hospitals) have a nonexistent antimicrobial stewardship program (AMSP). After successfully initiating AMSPs in tertiary care hospitals of India, the Indian Council of Medical Research envisages implementing AMSP in secondary care hospitals. This study is about the baseline data on antibiotic consumption in secondary care hospitals. Materials and Methods It was a prospective longitudinal observational chart review type of study. Baseline data on antibiotic consumption was captured by a 24-hour point prevalence study of antibiotic usage and bacterial culture rate. The prescribed antibiotics were classified according to the World Health Organization (WHO) Access, Watch, and Reserve classification. All data were collated in Microsoft Excel and summarized as percentages. Results Out of the 864 patients surveyed, overall antibiotic usage was 78.9% (71.5% in low-priority areas vs. 92.2% in high-priority areas). Most of the antibiotic usage was empirical with an extremely low bacterial culture rate (21.9%). Out of the prescribed drugs, 53.1% were from the WHO watch category and 5.5% from the reserve category. Conclusion Even after 5 years of the launch of the national action plan on AMR (NAP-AMR) of India, AMSP is still non-existent in small- and medium-level hospitals in urban cities. The importance of trained microbiologists in the health care system is identified as a fulcrum in combating antimicrobial resistance (AMR); however, their absence in government-run district hospitals is a matter of grave concern and needs to be addressed sooner than later. [ABSTRACT FROM AUTHOR]

Background Intestinal parasites are a major public health problem in tropical countries. Over 1.5 billion people are infected with soil-transmitted helminths (STH), of which 225 million are in India. Parasitic infections are associated with poor sanitation, lack of safe potable water, and improper hygiene. Materials and Methods The study was undertaken to ascertain the impact of control strategies, namely open-defecation free drive and mass drug administration of single dose albendazole. Stool samples received at AIIMS Bhopal Microbiology laboratory, across all age groups, were studied for protozoan trophozoites/cysts and helminthic ova. Results Out of 4,620 stool samples, 389 (8.41%) were positive either for protozoal or helminthic infections. Protozoan infections were more common than helminthic infections with Giardia duodenalis infection being the most common, 201 (51.67%), followed by Entamoeba histolytica , 174 (44.73%). The helminthic infections constituted 14 (3.5%) of the positive stool samples with Hookworm ova in 6 (1.5%) cases. Conclusion This study proves that strategies, namely "Swachh Bharat Abhiyan" and "National Deworming Day" started in 2014 and 2015 led to significant reduction of intestinal parasite infections in Central India, with a higher reduction of STH compared with protozoan parasite infection being ascribed to the activity spectrum of albendazole. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of human papilloma virus (HPV) infection and the pattern of HPV genotype distribution are much-needed parameters to assess the risk of cervical cancer among females. However, due to less availability of data on HPV burden and its genotypes from various geographical regions in India makes cervical cancer screening modalities and vaccination strategies difficult to implement.Objective: The present study was conducted to identify the various genotypes particularly high-risk HPV types in premalignant or malignant cervical lesions.Methods: The study was a hospital-based cross-sectional study wherein 295 symptomatic women were screened by Pap smear and multiplex real-time PCR was performed for HPV genotypes identification in women with abnormal cervical cytology.Results: Out of 295 women, 237 (80.3%), 45 (15.3%), and 13 (4.4%) women had normal Pap smear, squamous cell carcinoma and precancerous cytology, respectively. Among these 58 women having abnormal cervical cytology, HPV was detected in 48 (81.0%) participants. Most common HPV genotypes in our study were HPV 16 (n = 29; 60.4%) followed by mixed infections; i.e., more than one type of HPV was detected (n = 10, 20.8%). HPV 18 was detected only in 6.25%, whereas other high-risk HPV genotypes were found to be 12.5%.Conclusion: HPV positivity was >80% in women having abnormal Pap smear. The prevalence of HPV 18 was found to be much less in Central India, compared to other parts of country. HPV 16 was the most common genotype followed by mixed HPV genotype infections. It is evident from our study that symptomatic women even if having normal Pap smear should be screened for HPV and followed up with periodic Pap smears for detecting any change in cervical cytology, thus preventing cervical cancer in women. [ABSTRACT FROM AUTHOR]

Introduction: Upper airway imaging can often identify the anatomical risk factors for sleep apnea and provide sufficient insight into the pathophysiology of obstructive sleep apnea (OSA). Materials and Methods: We conducted a case–control, observational study at a tertiary care hospital in North India. All cases and controls underwent lateral cephalometry and magnetic resonance imaging (MRI) for craniofacial and upper airway evaluation. Only the cases had polysomnography testing for confirmation of OSA and assessing the severity of disease. Results: Forty cases and an equal number of matched controls were recruited. On X‑ray cephalometry, it was observed that the cases had a significantly larger hyoid mandibular distance and soft palate length; and shorter mandibular length. The MRI cephalometric variables were significantly different, the soft palate length, tongue length, and submental fat were longer while the retropalatal and retroglossal distance was shorter amongst the cases. A statistically significant positive correlation was found between the cephalometric parameters and the indices of severity of OSA. An increased hyoid mandibular distance and soft palate length, and a decrease in the lower anterior facial height were found to be predictive of severe OSA (Apnea–Hypopnea Index –>30/h). An increased hyoid mandibular distance, soft palate length, and the tongue length and a reduced mandibular length were found to be predictive of need for continuous positive airway pressure (CPAP) pressures of ≥15 cm H2O. There were significant differences between the cephalometric parameters of the Indian OSA patients and patients from other ethnicities reported in the literature. Conclusions: OSA patients had a significantly smaller upper airway compared to age‑, sex‑, and body mass index‑matched controls and cephalometric variables correlated with the indices of OSA severity. The cephalometric assessment was also predictive of severe OSA and the need for higher pressures of CPAP. This indicates the important role of upper airway anatomy in the pathogenesis of OSA. [ABSTRACT FROM AUTHOR]

Introduction: We prospectively evaluated EUCAST rapid antimicrobial susceptibility testing methodology for susceptibility testing directly from blood culture bottles in comparison to CLSI disk-diffusion method., Methodology: During May-November 2019, positively flagged blood culture bottles showing Gram-negative micro-organisms were simultaneously processed by rapid antimicrobial susceptibility testing and CLSI methodology. Antibiotics tested were cefotaxime, ceftazidime, piperacillin-tazobactam, imipenem, meropenem, gentamicin, tobramycin and trimethoprim-sulphamethoxazole., Results: Overall, 80 isolates identified as Escherichia coli (n = 24, 30%), Klebsiella pneumoniae (n = 15, 18.7%), Pseudomonas aeruginosa (n = 16, 20%) and Acinetobacter baumannii (n = 25, 31.2%) were included. Categorical agreements  of rapid antimicrobial susceptibility testing at 4-, 6- and 8-hour reading times were 88.1% (304/345), 90.8% (425/468) and 92.3% (467/506), respectively. Major Error rates were 14% (21/150), 4.9% (10/206) and 4/236 (1.7%), whereas Very Major Error rates were 1.1% (2/177), 1.3% (3/232) and 3.3% (8/243), respectively. Results categorized as "Area of Technical Uncertainty" were significantly lower at 8-hour {10.2% (39/384) vs 5.2% (28/534), 4- vs 8-hour, p = 0.003, Fischer's exact test}., Conclusions: Except for a slightly higher Very major error rate, rapid antimicrobial susceptibility testing at 8-hour is equivalent to Disk-diffusion method (CLSI-M100) using CLSI-M52 criteria for equivalence: (Categorical agreement ≥ 90%, Very major error ≤ 1.5% and Major error ≤ 3%). Poor Categorical agreements at all reading times were noted for piperacillin-tazobactam, ciprofloxacin and E. coli. Performance of rapid antimicrobial susceptibility testing methodology in resource limited settings brings unique challenge of identifying micro-organisms within 8 hours. We suggest reading and reporting of results at a single time point using rapid antimicrobial susceptibility testing method i.e. at 8-hour., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Mohammad Aadam Bin Najeeb, Ayush Gupta, Shashank Purwar, Vishnu Teja Nallapati, Jogender Yadav, Farha Siddiqui.)

Global scarcity of freshwater has been gearing towards an unsustainable river basin management and corresponding services to the humans. It needs a holistic approach, which exclusively focuses on effective river water quality monitoring and quantification and identification of pollutant sources, in order to address the issue of sustainability. These days, rivers are heavily contaminated due to the presence of organic and metallic pollutants released from several anthropogenic sources, such as industrial effluents, domestic sewage, and agricultural runoff. It is astonishing to note that even in many developing countries, most of these contaminants are carried through open drains, which enter river premises without proper treatment. Such practice not only devastates riverine ecosystem but also gives rise to deadly diseases, such as minimata and cancer in humans. Considering these issues, the present study develops a novel approach towards simultaneous identification of major sources of pollution in the rivers, along with critical pollutants and locations using an advanced hierarchical cluster and multivariate statistical analysis. A systematic approach has been developed by agglomerating both R-mode and Q-mode analysis, which develops monoplots, two-dimensional biplots, rotated component matrices, and dendrograms (using "SPSS" and "Analyse It" software) to reveal relationships among various quality parameters to identify the pollutant sources along with clustering of critical sampling sites and pollutants. A case study of the Ganges River Basin of India has been considered to demonstrate the efficacy and usefulness of the model by analyzing 85 open drains. Both organic and metallic pollutants are analyzed simultaneously as well as separately to get a holistic understanding of all the relationships and to broaden the perspective of water characterization. Results provide a comprehensive guidance to the policy makers and water managers to optimize corrective efforts, minimize further damage, and improve the water quality condition to ensure sustainable development of the river basin.

Background & Objectives: Healthcare associated infections (HAIs) are responsible for morbidity and mortality among immunocompromised and critically ill patients. We undertook this study to estimate the burden of HAIs in the paediatric cancer patients in a tertiary care hospital in north India., Methods: This prospective, observational study, based on active surveillance for a period of 11 months was undertaken in a 4-bedded isolated, cubicle for paediatric cancer patients. Patients who stayed in the cubicle for ≥48 h, were followed prospectively for the development of HAIs., Results: Of the 138 patients, 13 developed 14 episodes of HAIs during the study period. Patient-days calculated were 1273 days. Crude infection rate (CIR) and incidence density (ID) of all HAIs were 9.4/100 patients and 11/1000 patient-days, respectively. Of the 14 episodes of HAIs, seven (50%) were of blood stream infections (HA-BSI), five (36%) of pneumonia (HAP) and two (14%) urinary tract infections (HA-UTI). The CIRs of HA-BSI, HAP and HA-UTI were 5.1, 3.6 and 1.4/100 patients, respectively. The corresponding IDs were 5.5, 3.9 and 1.6/1000 patient-days, respectively. Mean length of stay was significantly higher in patients who developed an HAI [13.8 (range 7-30), median (Interquartile range) 12 (11-14)] vs 7.5 days [range 2-28, median (interquartile range) 7 (5-9); P<0.0001]. Also mortality was significantly higher in patients who developed an HAI [23% (3/13) vs 3% (4/125), P<0.05]., Interpretation & Conclusions: The incidence of HAIs in the paediatric cancer patients in the study was 11/1000 patient days, of which HA-BSIs were the commonest. HAIs were associated with an increase in morbidity and mortality amongst this high risk patient population.