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• LAI-REACT was a single center, proof-of-concept, observational study. • Triple combination REB regimen was evaluated in 128 patients with ACS. • Triple combination REB regimen was found to be highly efficacious, safe and affordable. • 59.6% of patients achieved LAI target LDL-C < 50 mg/dl within the first week. • The reductions in LDL-C levels were sustained through 6 weeks of follow-up. • REB regimen was associated with a significant reduction in hsCRP levels. Rapid reduction of low-density lipoprotein cholesterol (LDL-C) to target levels immediately following acute coronary syndrome (ACS) event is critical to prevent future events. High-dose statins alone often fail to achieve LDL-C goals. Proprotein convertase subtilisin/kexin type-9 inhibitors (PCSK9i) combined with high-dose statins improves LDL-C goal attainment, but is unaffordable for many patients in India and worldwide. In a real-world open-label study, we demonstrated in a cohort of 122 patients with ACS, concurrent triple therapy with rosuvastatin 40 mg/d, ezetimibe 10 mg/d, and bempedoic acid 180 mg/d (REB) started at the time of hospital admission was associated with 57.7%, 61.7%, 61.9% and 60.6% reductions in LDL-C from 115.6 mg/dl at baseline to 48.9 mg/dl at week 1, 44.3 mg/dl at week 2, 44.1 mg/dl at week 4, and 45.6 mg/dl at week 6, respectively (each p < 0.001 compared to baseline; p < 0.001 across repeated measures). REB provided significant reductions in LDL-C within as early as one week and enabled 76.3% and 92.2% of patients to achieve the Lipid Association of India and American College of Cardiology recommended LDL-C targets of <50 mg/dl and <70 mg/dl within 2-weeks, respectively, which were sustained at 4–6 weeks. REB was generally well tolerated. Our study demonstrates the capacity to rapidly achieve LDL-C goals after ACS with triple REB therapy, an affordable regimen in India. [ABSTRACT FROM AUTHOR]

This paper assessed the impact of natural resource management technology (NRCT) on productivity and efficiency in maize production using an endogenous switching regression model in rainfed areas of Southern India. We also identified factors influencing adoption of NRCT, and technical efficiency in maize production. For this study, plot-level primary data from 303 farm households cultivating maize on 419 plots were collected. Results show that adoption of NRCT has resulted in an increase in maize productivity by 490 kg per ha and has also reduced technical inefficiency by 28% as compared to non-adopters. Furthermore, access to credit, better extension services and training on natural resource management are crucial factors positively affecting the adoption of NRCT as well as enhancing the technical efficiency of maize production. Therefore, these factors need to be considered when formulating policies and programmes that aim to improve crop productivity in rainfed areas, as well as sustaining natural resources. [ABSTRACT FROM AUTHOR]

Background: Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, patient stay, and cost. The importance of good oral hygiene for patients in intensive care units (ICUs) is well recognized, however, the most effective way to achieve good oral care in the ICU is unclear. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of nursing professionals regarding oral healthcare in ICUs among various medical institutes across India. Materials and methods: A questionnaire-based multicentric cross-sectional survey was conducted among registered nursing professionals employed at ICUs of three government tertiary healthcare centers (THC) of India: THC-I, THC-II, and THC-III located in the eastern and northern parts of India between February 2022 and July 2022. Results: A total of 150 nurses completed the questionnaire form (response rate: 62.5%) comprised of 49 (32.7%) males and 101 (67.3%) females with a mean age of 35.69 ± 7.7 years. Nursing officers' knowledge surpassed that of staff nurses regarding the duration of toothbrushing (p = 0.033). Among interinstitutional comparisons, THC-I nurses showed the greatest knowledge regarding the duration of toothbrushing and the mechanism of preventing saliva accumulation to reduce microbial growth (p = 0.013 and p = 0.003, respectively). Based on total work experience, participants were segregated into three groups: Group I (<7 years), group II (7.1-13.9 years), and group III (>14 years). Group II surpassed the knowledge of denture removal during sleep, cleaning after every meal, and storing in personalized air-tight containers (p = 0.001 and p = 0.036, respectively). The majority from group II recommended plain saline as the material for oral hygiene maintenance in ICU patients (p = 0.008). Group III predominantly practiced the ideal handwashing technique pre- and post-patient contact which was statistically significant (p = 0.001). Conclusion: This study observed that a knowledge gap exists among the nurses of the three institutes across India pertaining to the oral hygiene care of ICU patients. Nurse's education and implementation of the proper oral hygiene measures for intubated patients in ICU setup is an essential need. [ABSTRACT FROM AUTHOR]

The Government of India has launched the Green Credit Programme (GCP)--a market-based voluntary programme--to enhance energy and resourceuse efficiency, foster conservation of resources, mitigate climate change, and strengthen adaptive capacity. The programme intends to incentivize the adoption of environmentally sustainable technologies and processes through fiscal and financial nudges and effect behavioural changes. The efficacy of a policy programme depends on its design and implementation, though, in theory, such programmes are designed to be cost-effective, environmentally favourable, as well as economically inclusive. The success of a tradable programme should be judged on the basis of four parameters: design of the programme, minimization of transaction costs, market volatility, and leakage and environmental degradation. The GCP administrators have yet to issue an effective design and implementation framework for the programme. [ABSTRACT FROM AUTHOR]

Technical institutions (TIs) are playing an important role in making India a knowledge hub of this century. There is still great diversity in their relative performance, which is a matter of concern to the education planner. This article employs the method of data envelopment analysis (DEA) to compare the relative efficiency of TIs in India. The identification of the strongest and the weakest parameters of various TIs could be very useful in improving their efficiency and performance. Mathematically, DEA determines the best weights for each input and output for a particular unit under study so as to maximize its relative efficiency. The results are insightful to the educational planner as it identifies priority areas for each technical institute, which can improve the performance. This article also identifies some generic insights from this study. This article is one of the few published studies that evaluate the performance of technical institutes in India. (Contains 1 figure and 2 tables.)

Male breast cancer (MBC) is a rare affliction accounting for approximately 1% of all breast cancer cases. The treatment guidelines of MBC mirror those of female breast cancer which are derived mostly from data obtained from studies involving female breast cancer patients. Data on MBC are mostly limited to single-institution studies due to the rarity of the disease. This study was undertaken to assess retrospectively the pattern of demographic and clinicopathological factors in MBC treated at our tertiary care center. Materials and Methods: Records of MBC treated between January 2019 and December 2020 in our institute were analyzed and data regarding the demographic and clinicopathological profile of patients was recorded. Observational retrospective single centre study. Results: A total of 12 patients of MBC were encountered with a median age of 58 years. The painless lump was the most common presentation with the retro-areolar region being the most commonly involved site. The most common American Joint Committee on Cancer anatomical stage group observed was Stage II with the left breast being involved more than the right. None of the patients had a family history of breast carcinoma. Out of the 12 patients, 10 patients were positive for hormonal receptors, whereas only two patients showed human epidermal growth factor receptor 2 amplifications. Conclusion: MBC is a rare disease. Further multi-institutional studies involving a larger number of patients are needed for a better understanding and formulation of gender-specific guidelines for the effective management of MBC. [ABSTRACT FROM AUTHOR]

This study estimates the distributional heterogeneity in the effects of climate change on yields of three major cereal crops: rice, maize, and wheat in India using district‐level information for the period 1966–2015. We distinguish between the effects of changes in growing season weather from those due to changes in long‐term climate trends and the heterogeneity in these effects across the distribution of crop yields by estimating naïve and climate penalty inclusive models using fixed‐effect quantile panel models. We observe an absence of adaptation against rising temperatures for rice and wheat. However, we find a statistically significant presence of adaptation for wheat and maize for changes in precipitation, though the magnitude is small. Moreover, we find that the effects are asymmetric, and are larger at the lower tail of productivity distribution and smaller at the upper tail of the distribution. A 1°C increase in temperature lowers rice and wheat productivity by 23% and 9%, respectively at the first quantile, but the damage is only 6% and 5% at the ninth quantile. Heterogeneity in impacts and adaptation estimates over the yield distribution curve and across crops suggests the importance of customizing strategies for adaptation to changing weather and climate conditions across regions, crops, and current productivity levels. [ABSTRACT FROM AUTHOR]

Introduction: A multicentric study on the benefits and outcomes of e-learning was lacking during the pandemic. This study aimed to find out the participation, satisfaction, and insights of dental and medical undergraduate learners toward digital learning during the COVID-19 pandemic in various healthcare institutes of India. Material and Methods: A questionnaire-based cross-sectional study was conducted using Google Forms online on e-learning among students from the first to the final year of MBBS and BDS courses in five healthcare institutions. Results: Most participants (72.7%) reported cellular data as their mode of internet connection. Seventy point eight percent of participants stated online classes did not affect health. Eyestrain (54.6%) was the most common, followed by headache and fatigue, whereas only 21.2% chose obesity and disturbed sleep as a consequence of e-learning. Conclusion: Most students had experience in digital learning, in which the use of smart phones with cellular data was the most common mode of digital learning during the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Rhino-orbito-cerebral Mucormycosis (ROCM) is an uncommon but devastating fungal infection caused by Mucoraceae family fungi, which are angiotropic and filamentous, with significantly high morbidity and mortality despite treatment. Post Coronavirus Disease-2019 (COVID-19), there was a sudden surge in ROCM cases nationwide due to immunologically and metabolically compromised status. Aim: To describe retinal manifestations in ROCM in a tertiary eye care centre of Northern India. Materials and Methods: An analytic, cross-sectional and hospitalbased study was conducted in Regional Institute of Ophthalmology, PGIMS Rohtak, Haryana, India, from May 2021 to September 2021. This study was conducted on 200 admitted patients of RCOM in the institute, which was only designated Nodal centre in Haryana, India. Detailed history was recorded in every patient regarding presenting symptoms, history of COVID-19, hospital stay, oxygen inhalation, steroid intake and immunisation. Thorough ocular examination was done in every patient including visual acuity, ocular movements and pupillary reactions. Dilated fundus examination was done by Indirect Ophthalmoscopy (IDO) for posterior segment evaluation. Contrast Enhanced Magnetic Resonance Imaging (CE-MRI) brain with orbit and Paranasal Sinus (PNS) was done in every patient to see the extent of spread and planning further management. Results: Out of 200 patients of ROCM, majority of patients (64/200) were of 51-60 year age group (32%) followed by 41-50 year age group (28%). Out of 200 cases of ROCM, 146 patients (73%) had history of COVID-19 infection in past and 134 (67%) patients had history of hospital stay during COVID-19 infection. Oxygen (O2) supplementation was given to 98 patients either at home or during hospital stay. History of steroid intake was present in 34 patients and 46 patients received injection Remedsivir. Only 12 patients had vaccine against COVID-19 and none of them were fully vaccinated. Most common presenting symptom was unilateral nasal stiffness (22%) followed by loss of vision (17%). Most common predisposing factor was Diabetes Mellitus (DM) in 78 patients (39%) followed by steroid intake in 34 patients (17%). Out of 200 patients, only 60 patients had retinal manifestations and most common was Central Retinal Artery Occlusion (CRAO) (35/60) and the main mechanism is the direct infiltration of central retinal artery due to angioinvasion of fungi from the orbit. Conclusion: CE-MRI brain with orbit is an important tool in diagnosing and monitoring progression of RCOM but it cannot provide information regarding retinal findings like CRAO, central retinal venous occlusion (CRVO), disc pallor and optic atrophy. Thus, the fundus examination of every ROCM patient should be emphasised, as it not only helps in categorising ROCM but also tells about the visual potential of affected eye. Patients with CRAO and combined vascular occlusion should be considered for exenteration on urgent basis, so that intracranial spread can be prevented and patient's life can be saved. [ABSTRACT FROM AUTHOR]

The impact of SARS‐CoV‐2 infection in pregnant women and their neonates is an area of research interest nowadays. To date, there is limited knowledge about SARS‐CoV‐2 prevalence, maternal and perinatal outcomes of pregnant women at term in middle‐ and low‐income countries. In the present retro‐prospective study, medical records of pregnant women admitted for delivery were reviewed from the largest Covid‐19 dedicated Shri Maharaja Gulab Singh (SMGS) maternity hospital. The SARS‐CoV‐2 screening was carried out for all pregnant women admitted for delivery using RT‐PCR. All neonates born from SARS‐CoV‐2‐positive mothers were isolated and tested for SARS‐CoV‐2 infection. Most of the pregnant women (90.6%) were asymptomatic at the time of admission with a low prevalence (3.4%) of SARS‐CoV‐2. A higher rate of asymptomatic prevalence (86.1%) was found among SARS‐CoV‐2‐positive pregnant women. On the basis of the RT‐PCR result (negative vs. positive), statistically significant differences were found for maternal characteristics, such as mean gestational age (37.5 ± 2.2 vs. 36.6 ± 3.3), medical comorbidity (2.9% vs. 7.4%), and maternal outcomes like the C‐section rate (29.8% vs. 58.3%), preterm delivery (14.6% vs. 28.3), and neonatal outcomes like mean birth weight (2840 ± 450 vs. 2600 ± 600), low Apgar score (2.7% vs. 6.48%), and fetal distress (10.9% vs. 22.2%) among SARS‐CoV‐2 negative and positive cases, respectively. No neonate from SARS‐CoV‐2‐positive pregnant women was found to be positive for SARS‐CoV‐2 infection. Highlights: SARS‐CoV‐2 infection has deleterious effects on maternal characteristicsobstetric complicationsmaternal and perinatal outcomes among pregnant women admitted for delivery [ABSTRACT FROM AUTHOR]

We estimate carbon mitigation cost (CMC) and the factors determining change in CMC using environmental production function. The CMC index is defined as the ratio of maximum production of electricity under unregulated and regulated production technology. Change in CMC index is decomposed into technical change, scale change and change in the level of CO2 emissions. The production function is estimated for 45 coal-fired thermal power plants over the period of 2008–2012 using data envelopment analysis. Decomposition of CMC change reveals that impacts of changes in scale of operation and CO2 emissions were more than the reduced costs realized due to technical changes. We find that the sample plants in Indian coal-fired thermal power sector had to sacrifice about 3.5% of electricity production amounting to 2005US$ 1702 million of revenue loss over the 5 years due to regulation of CO2 emissions. [ABSTRACT FROM AUTHOR]

Background: The assessment of newborns' heart rate (HR) in the delivery room is one of the important steps to ascertain the need for initiation and continuation of resuscitation. At present, ECG is the "gold standard" to monitor neonatal HR in the delivery room. However, various limitations with the use of ECG exist. Furthermore, in developing countries, ECG may not be universally available in delivery rooms.Objective: To compare the accuracy and HR acquisition time of portable Doppler ultrasound (PDU) versus electrocardiogram (ECG) in newborns.Methods: This multicenter, prospective, observational study across five centers in India between January and September 2017 included neonates more than 34 weeks of gestation (n = 131) delivered by cesarean section. The accuracy of HR recorded by PDU (HRPDU) versus that by ECG (HRECG) was the primary outcome. Secondary outcomes included time to acquisition of an audible and/or visible signal and device application.Results: Mean (±SD) gestational age and birthweight were 37.7 (±1.2) weeks and 2954 (±457) g, respectively. The mean (±SD) visible HRPDU was 158 (±21) bpm versus HRECG of 161.3 (±20) bpm (p = .07) which were comparable. The median (1st, third quartile) time to acquisition of audible HRPDU (76 [51, 91] s), was significantly shorter than that of HRECG (96.5 [74.2, 118] s; p < .001).Conclusion: Portable Doppler has similar accuracy to ECG and is faster in acquiring the signal. [ABSTRACT FROM AUTHOR]

Background: Because of low utility, feeding of male buffalo calves is ignored in India leading to high mortality and poor growth in surviving calves. However, the meat of buffalo calves has considerable collagen solubility and serves as a remarkable source for meat products. As the addition of potassium chloride in meat products is restricted owing to its bitter taste and metallic flavor, potassium lactate can serve as a potential source for sodium chloride and it also alleviates the function of sodium chloride in meat processing. Methods: Low salt buffalo calf meat rolls were prepared by partially substituting sodium chloride with potassium lactate at 10%, 20%, 30%, 40% and 50% levels maintaining equivalent ionic strength. Sensory quality, physico-chemical attributes, proximate composition, instrumental texture, firmness, toughness and color were evaluated. Result: Substitution up to 30% level did not cause any significant alteration in sensory quality but further enhancement in potassium lactate level resulted in a significant decrease in flavor, texture, juiciness, tenderness and overall acceptability. The replacement did not cause any significant decline in proximate composition, water holding capacity and emulsion stability of developed meat rolls. An increase in pH and decrease in cooking yield was noticed with an increase in the level of potassium lactate but a significant impact was noticed only at 50% substitution. Texture profile and instrumental color of potassium lactate treated rolls were comparable with control samples. Firmness and toughness decreased with enhancing the level of potassium lactate but the significant impact was recorded only at 50% level. [ABSTRACT FROM AUTHOR]

This paper empirically measures the impact of sectoral energy price differential between trading partners on Indian exports. Using dynamic gravity model, we estimate the response of Indian exports for 11 energy-intensive sectors to sectoral-level energy price asymmetry. We observe the absence of the contemporaneous effect of energy price differential on Indian exports, but the presence of persistence effects. We find that a 10% increase in relative energy prices negatively affects Indian sectoral exports by about 1% ranging from 0.9% for chemicals to 1.4% for non-ferrous metals, revealing a larger impact for energy-intensive sectors. These small effects imply that the concerns of carbon leakage are largely overplayed. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to show the effects of routine vs. selective fortification of human milk (HM) on short-term growth and metabolic parameters.Methods: Single-centre retrospective pre-post cohort study in India. Preterm infants ≤32 weeks' gestation and weighing ≤1500 g were included. Routine fortification: pre-fixed feed volume (100 ml/kg/day in our unit) at which fortification was done. Selective fortification: feed volume was gradually optimized till 180-200 ml/kg/day. If weight gain was below the expected threshold (<10 g/kg/day), then fortification was considered. Primary outcome measure was rate of growth till discharge.Results: The median rate of weight gain (g/kg/day) in the routine fortification group [10.8 (3.3, 17.1)] was comparable with that in the selective fortification group [8.4 (0, 14.2), p = 0.6]. Serum phosphorus showed a significantly higher value (5.9 vs. 4.8, p = 0.03), while rest of the metabolic parameters showed a trend towards a favourable outcome in the selective fortification group. Adverse outcomes showed a trend towards decreased feed intolerance, necrotizing enterocolitis, and sepsis in the selective fortification group.Conclusions: Selective fortification had a comparable growth rate and showed a trend towards better metabolic parameters and lesser adverse outcomes compared with routine fortification of HM. [ABSTRACT FROM AUTHOR]

This study explains a deeper understanding of the effectiveness of social media sites on different parameters of consumer buying behavior. It estimated the relationship between several independent variables such as composite buying behavior, usual buying behavior, and variety-seeking buying behavior, disagreement buying behavior, impetuous buying behavior and consumer buying behavior as dependent variable in the electronic appliances market. The study focused to determine the factors affecting consumer preference and behavior in the Indian electronic market. This study majorly focused on the young working women using electronics product across Maharashtra in India. The data collected from 1272 working women. The major findings of the study indicates there is the positive effect of social media on variety seeking buying behavior, disagreement buying behavior, usual buying behavior, composite buying behavior and impetuous buying behavior. This study helps producers and retailers in understanding consumers buying behavior towards electronics appliances and also helps in improving the customer satisfaction. [ABSTRACT FROM AUTHOR]

Background: In 2016, there was a massive outbreak of chikungunya in North India. During the epidemic, we observed many neonatal and early infantile cases of chikungunya, with a probable perinatal transmission.Methods: This retrospective study was carried out in a tertiary care neonatal centre between August 2016 and November 2016. Chikungunya virus (CHIKV) infection was detected and confirmed by reverse transcription-polymerase chain reaction (RT-PCR) and/or serology (anti-CHIKV IgM) in mothers and infants. Clinical features and laboratory parameters were recorded.Results: There were 16 cases of confirmed CHIKV infections during the study period. For babies presenting during the neonatal period (n = 13), the median age of presentation was 9.5 (range: 3-15) days, whereas for babies (three) presenting after the neonatal period, the median age was between 1 and 3 months. The most common presentation was fever (69%), followed by lethargy (56%) and seizures (50%). Skin manifestations were observed in 25% of the cases, which included maculopapular rashes, bullous lesions and hyperpigmentation over the axilla, perioral and genital areas. None of the cases had any feature of arthritis. Of all the cases included in the study (n = 16), RT-PCR for CHIKV was positive in 14 (87.5%), whereas the serum anti-CHIKV IgM antibody test was positive in two (12.5%) cases. Six (37.5%) cases were documented as perinatal CHIKV, as RT-PCR for CHIKV was positive in both mothers and babies. Fifteen babies survived and were discharged in a stable condition with no oxygen requirement and on full feeds. One baby died because of multi-organ failure and catecholamine refractory hypotension.Conclusion: In endemic areas, paediatricians should have a low threshold of suspicion for perinatal or neonatal chikungunya in any infant presenting with signs and symptoms mimicking sepsis, especially with skin manifestations, seizure and/or encephalopathy. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM), the leading type of diabetes, has a typical association with coronary heart disease. In India, patients with diabetes are at an increased risk of developing coronary disease as compared to people without diabetes and this suggests the requirement of intensive treatment of cardiovascular (CV) risk factors. Consequently, there is a need for an intervention that could target CV risk factors in multiple paths beyond hyperglycemic control alone. Although metformin is the mainstay of treatment in most of the patients with T2DM, a second line of treatment with anti-hyperglycemic agent is warranted in patients with T2DM in the management of CV risk factors beyond glycemic control. Sodium glucose co-transporter-2 (SGLT-2) inhibitors, the oral hypoglycemic drug, that act independent of insulin secretion are associated with a reduced risk of hypoglycemia which is associated with the increased risk of CV events. Moreover, it has been observed that the use of SGLT-2 inhibitors in patients with T2DM is associated with reductions in blood pressure and body weight beyond improved glycemic control. In this article, the clinical efficacy, safety, and tolerability of SGLT-2 inhibitors on glycemic, nonglycemic parameters, and CV outcome including data from the EMPA-REG OUTCOME study are discussed. The EMPA-REG OUTCOME study is the first CV outcome study that demonstrated the association of a glucose lowering agent with the reduced CV mortality and all-cause mortality, and reduced hospitalization for heart failure in patients with T2DM at high risk of CV events. Although the mode of action associated with the CV benefits remains unknown, data from ongoing trials including DECLARE-TIMI (Dapagliflozin Effect on CV Events) and CANVAS (Canagliflozin CV Assessment Study) trials potentially can validate the class-effect for SGLT-2 inhibitors regarding the CV outcomes. [ABSTRACT FROM AUTHOR]

The paper empirically examines the trade led growth paradigm for India with respect to SAARC countries for the period 1990-2014. The paper uses the co-integration model to test the causal relationship between trade and output growth. Granger causality test is applied for the period 1994-2015 to examine the nature of relationship between variables under study. The results indicate absence of long term relationship between India's GDP growth and trade among SAARC nations, thereby giving way to the existence of short term relationship. Granger causality revealed unidirectional nature of causality from exports to GDP and Imports to GDP for Nepal, Pakistan and Sri Lanka, GDP to export for Maldives, GDP to import for Bangladesh, Import to export for Bhutan and Sri Lanka and export to import for Pakistan. [ABSTRACT FROM AUTHOR]

This article examines the motivations for firms in India to participate in voluntary environmental programs (VEPs) using a unique data set of cement, power and steel industry for the year 2012. It examines the effects of regulatory, societal, market and internal factors in influencing voluntary environmental behavior. To this objective we estimate both, ordinal (Ordered Probit) and cardinal (Poisson) models. We find that the firm size, its location, export orientation, and intangible valuation have a positive and significant relationship with the number of VEPs undertaken by the firm. The MNC status of the firm has no impact while the debt equity ratio and average age of the firm has negative impact on the adoption of VEPs. [ABSTRACT FROM AUTHOR]

Current regulatory mechanism is costly and ineffective due to weak enforcement of environmental standards in India. Harnessing the capabilities of capital markets could be a better strategy for environment friendly economic growth. Therefore, the paper aims to examine a relationship between a firm’s environmental performance and its market valuation. The study uses market value as an indicator of the financial performance using the Ohlson (Contemp Account Res 11:661-687, 1995) model, which is a better indicator in an emerging economy compared to Tobin-q and is free from the biases that Tobin-q suffers from. The study finds a positive relationship between the number of voluntary environment program implemented by a firm and its market value and significant negative relationship between a firm’s market value and pollution index. However, the relationship between resource use index and market value is not found to be statistically significant. The study indicates that India could harness the power of capital markets for improving industrial environmental performance. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is associated with advanced presentation in developing countries like India due to various socio-economic factors. The presence of BC molecular subtypes such as the triple-negative (TN) subtype adds to this menace. Androgen receptor (AR) is emerging as a new biological marker. The aim of this study was to examine the prevalence of AR with relation to different BC subtypes, and its role in predicting response to neoadjuvant chemotherapy. Methods: 116 cases of invasive BC (infiltrating ductal carcinoma, not otherwise specified) were evaluated. AR expression was correlated with clinicopathological factors, established prognostic markers, BC subtypes and it ability for predicting response to neoadjuvant chemotherapy. Results: AR was expressed in 56% of the cases. AR expression was significantly associated with early stage (p < 0.03), low axillary burden (p < 0.04), estrogen receptor (p = 0.002), progesterone receptor (p = 0.001) expression and luminal A molecular subtype. No significant association was observed with age, tumor size and HER2/neu status. One third of TNBC cases expressed AR. Higher AR expression corelated to good clinical response to neoadjuvant chemotherapy. Conclusion: AR can be utilized as a predictor of response to neoadjuvant chemotherapy especially in developing countries such as India where the load of advanced disease is high. [ABSTRACT FROM AUTHOR]

This paper presents the results of a study conducted on the use of internet services ofNehru Library, CCS Haryana Agricultural University, Hisar. Survey method was used to collect the data from the users with the help of structured questionnaires. The present study examined the different aspects of internet searching behavior of the students. The study shows that 35.52% of the users having more than 4 year experience with internet. The majority of the users i.e. 28.94% access the internet at daily basis. The most preferred place of using internet was 67.76% at Nehru Library. Most of the users were using internet for the web based library resources like CeRA, Indiastat, Krishi Prabha (etheses), e-learning portal and Britannica online etc. Google was the most favorite search engine among the users. The majority of the users were fully satisfied with the present internet services offered by the Nehru Library, CCS HAU, Hisar. [ABSTRACT FROM AUTHOR]

Since 1979, consistent and untiring efforts of Dr. D.R. Purohit, Dr. Mahaveer Chand Jain and Dr. G. D. Koolwal against the odds have brought remarkable changes in the Psychiatric centre, Jodhpur. [ABSTRACT FROM AUTHOR]

Blood samples were collected during August 1992 and August 2002 from various hospitals of Haryana state and analyzed for the presence of HCH and DDT residues and the change in concentration of pesticide residues was calculated in terms of % reduction. The study revealed that the mean residue levels of total HCH in human blood samples have declined by 87.6 % while those of total DDT have decreased by 98.9 % during a gap of 10 years. The obtained results reveal that during 1992 p,p′-DDT was the major component with the mean value of 6.125 mg/L followed by p,p′-DDE, γ-HCH, α-HCH and β-HCH while in 2002, β-HCH and p,p′-DDE were comparable with mean value of 0.053 and 0.052 mg/L, respectively followed by p,p′-DDT, α-HCH and p,p′-DDD. [ABSTRACT FROM AUTHOR]

The design and implementation of environmental policy often involve more than one pollutant, and must consider pollution as a byproduct of the production of marketable output. In this paper, we test the implicit assumption in the empirical literature that (1) production of marketable output, pollution and abatement are separable, and (2) different pollutants can be abated separately. Using unique plant-level data in India, we reject the null hypotheses of separability between marketable output and pollutants, and between different pollutants. Firms must incur abatement costs for reducing pollution levels. In addition, complement and substitute relationships between water pollutants are demonstrated with statistical significance. [ABSTRACT FROM PUBLISHER]

Campus suicides have increased manifold across academic institutions, often leaving unresolved bereavement issues in these institutions, primarily because students are supposed to carry on with their daily activities with little or no time and attention paid to this necessary process. In this study, the role of cognitive-emotional processes in coping, especially when one is grieving a death, was investigated through a comparison between 40 bereaved Japanese and Indian female college students. The participants were assessed for resilience, cognitive-emotional regulation, posttraumatic cognition, and coping strategies in the aftermath of the suicide death of someone close. Positive reappraisal mediated the relationship between resilience and proactive coping, whereas negative cognitions about the self mediated the relationship between resilience and proactive as well as reflective coping. The participants from the two cultures differed significantly on resilience, with Indians scoring higher than Japanese young adults. The findings are analyzed in light of the coping with distressful life events model and could have possible implications for social workers and/or mental health professionals in terms of acceptability of interventions. [ABSTRACT FROM AUTHOR]

The conventional measures of benchmarking focus mainly on the water produced or water delivered, and ignore the service quality, and as a result the 'low-cost and low-quality' utilities are rated as efficient units. Benchmarking must credit utilities for improvements in service delivery. This study measures the performance of 20 urban water utilities using data from an Asian Development Bank survey of Indian water utilities in 2005. It applies data envelopment analysis to measure the performance of utilities. The results reveal that incorporation of a quality dimension into the analysis significantly increases the average performance of utilities. The difference between conventional quantity-based measures and quality-adjusted estimates implies that there are significant opportunity costs of maintaining the quality of services in water delivery. [ABSTRACT FROM AUTHOR]

Wheat is a predominant crop of India and required a costly preparatory tillage practice with 8-10 ploughing. Wheat crop can be grown by using zero tillage technology without preparatory tillage. Through using this technology we can minimize the cost of cultivation without decreasing the production and productivity same time sowing date became 25-30 days early which is primary requirement of getting the maximum potential yield of wheat, resulting net return increased 4000- 5000 Rs./Hectare by minimizing the cost of cultivation in same ratio. As per finding of the study farmers are having favourable attitude toward this technology and they are still using with rapidly adoption. Present study was conducted in Baghpat, Saharanpur, Meerut and Muzaffarnagar district or Western Uttar Pradesh. [ABSTRACT FROM AUTHOR]

This paper studies mechanisms to compensate local government for the public provision of environmental services using the theory of optimal fiscal transfers in India. Especially, we analyzed the role of intergovernmental fiscal transfers in achieving the environmental goal. Simply assigning the functions at appropriate levels does not ensure optimal provision of environmental services. Optimality in resource allocation could be achieved by combining the assignment system with an appropriate compensation mechanism. Intergovernmental fiscal transfers would be a suitable mechanism for compensating the local governments and help in internalizing the spillover effects of providing environmental public goods. Illustrations are also provided for India. [Copyright &y& Elsevier]

Technical and environmental efficiency of some coal-fired thermal power plants in India is estimated using a methodology that accounts for firm’s efforts to increase the production of good output and reduce pollution with the given resources and technology. The methodology used is directional output distance function. Estimates of firm-specific shadow prices of pollutants (bad outputs), and elasticity of substitution between good and bad outputs are also obtained. The technical and environmental inefficiency of a representative firm is estimated as 0.06 implying that the thermal power generating industry in Andhra Pradesh state of India could increase production of electricity by 6/ while decreasing generation of pollution by 6%. This result shows that there are incentives or win–win opportunities for the firms to voluntarily comply with the environmental regulation. It is found that there is a significant variation in marginal cost of pollution abatement or shadow prices of bad outputs across the firms and an increasing marginal cost of pollution abatement with respect to pollution reduction by the firms. This result calls for the use of economic instruments like pollution taxes instead of command and control regulation used currently in India to reduce air pollution. [ABSTRACT FROM AUTHOR]

Background: Teaching, training, and evaluation in general surgery has not been peer reviewed in India. An archaic 3 years residency, thesis writing, and evaluation at the end of 3 years leading to award of master's degree (MS) in general surgery has continued since 1950s. Immense growth in knowledge, emergence of new sub-specialties and surgical technologies has mandated a change in the existing surgical residency programme. Aim: To obtain a peer opinion on the existing surgical residency programme. Setting and Design: Cross sectional survey, 70 residents and 25 surgical teachers of five medical institutions, a pilot study in northern India. Materials and Methods: A close ended, interviewer-administered questionnaire based on 5-point Likert scale with 25 items of teaching, training, and evaluation on existing PG surgical residency programme. Results: Majority subjects felt that thesis was an important part of learning experience and it should continue. Opportunity to assist senior surgeons was adequate, but seniors should also assist the resident surgeon under training, a mentor-mentee type training pattern should be evolved, multiple evaluations on content, surgical skills, ethical, and managerial skills should evolve rather than a single examination conducted by internal/external examiners at the place of training after 3 years. A 5-years MCh in general surgery for academically oriented students including exclusive training in minimally invasive procedures, clinical epidemiology, pre-hospital and trauma management, and vascular surgery was suggested by many responders for a limited number of seats in general suregry. Conclusion: Broad-based training during general surgical residency in theoretical knowledge, open and endoscopic surgical skills, research methodology, critical appraisal, ethics and inter-personal skills should be part of revised programme along with multi-point evaluation and thesis writing. [ABSTRACT FROM AUTHOR]

Abstract: In this paper the input distance function is estimated for the Indian Sugar industry under alternative assumptions of weak and strong disposability of bad outputs. The estimated distance function is used to make the estimates of environmental efficiency, Malmquist productivity index and shadow prices of pollutants. The technical efficiency measure estimated under the assumption of weak disposability of bad outputs is utilized to test the Porter hypothesis. Marginal costs of pollution abatement functions are estimated for different pollutants of water. Pollutant specific taxes are computed using the tax-standards method. [Copyright &y& Elsevier]

Assesses the power sector in India. Electricity production; Impact of environmental regulation and pollution abatement on the production efficiency; Measurement of technical efficiency.

Estimates the economic value that people in an urban area in India place upon improving the air quality. Determinants of people's willingness to pay for air quality improvements; Use of the dose-response method to estimate the economic benefits of air quality improvement.

Vector-borne haemoparasitic diseases of migratory small ruminants have been less explored to date. Therefore, transhumant migratory sheep and goats of the Himalayas were molecularly screened for various vector-borne pathogens like Anaplasma, Theileria , Babesia , Anaplasma marginale , Theileria luwenshuni , Theileria orientalis, and Trypanosoma evansi using their specific primers. Out of the 171 animals screened, 73.09% of the animals were infected with Anaplasma spp. and 74.85% of the animals with Theileria spp., while no animals were found infected with Babesia spp. and Trypanosoma evansi. In a quest to identify the species, a few positive PCR amplicons representing Anaplasma spp., Theileria spp., and Theileria/Babesia spp. were sequenced. The sequences obtained were further BLAST analyzed to reveal maximum identity with Anaplasma capra (100%), Theileria luwenshuni (99.71%), and Theileria sinensis (98.73%). Among them Theileria luwenshuni was further confirmed with their species-specific PCR and the positive amplicons were sequenced and BLAST analysed to reveal their maximumsimilarity with Chinese isolates rather than Indian isolates. Further, phylogenetic analyses of the resulting sequences were conducted to identify their evolutionary history. It revealed that 1100 bp- amplicons of Theileria spp. were showing maximum likeness to Theileria sp. MK, a non-transforming Theileria. This is the first report of zoonotic Anaplasma capra and Theileria sp. MK in small ruminants from India and it could be mostly due to their transboundary migration history through the Indo-Tibetan border during summer seasons as a part of the traditional migratory system of livestock rearing practice in the Himalayas. The high prevalence of haemoparasites in migratory small ruminants calls for the adoption of effective control measures. • First report of Anaplasma capra , Theileria sp. MK from migratory small ruminants of India. • Anaplasma capra is zoonotic and therefore demands utmost attention. • Theileria sp. MK is a non-transforming Theileria closely related to Theileria orientalis. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the perception and practices of health care providers (physicians, diabetologists, and endocrinologists) regarding the treatment of hypertension in patients with diabetes in India., Methods: Health care providers throughout India who treated patients with diabetes and hypertension were invited to participate in an online survey and periodic 21 virtual meetings. They were questioned about their perception and practices in managing these patients, and strategies to improve blood pressure (BP)., Results: The online survey was completed by 2,513 health care providers, and 344 participated in virtual meetings. More than 50% reported that 31-50% of their patients with diabetes also had hypertension. Home BP monitoring was recommended by 88%, and lifestyle modifications were consistently recommended. Choice of antihypertensive treatment varied based on comorbidities, and a renin-angiotensin system blocker plus a calcium channel blocker (CCB) was the most common combination for dual antihypertensive therapy. Suggested strategies to improve BP control included patient awareness/education, lifestyle modifications, better follow-up/monitoring, and optimization of therapy., Conclusion: Indian health care providers were aware of clinical recommendations and practices regarding treatment of patients with diabetes and hypertension, and generally make clinical decisions consistent with current guidelines. Optimization of care for these patients is essential to reduce cardiovascular disease risk and improve patient outcomes., (© Journal of the Association of Physicians of India 2011.)

Aim: To assess the influence of gender and age on different parameters of alveolar bone loss using orthopantomogram., Materials and Methods: Eighty subjects were enrolled in the study (20 dentulous and 60 completely edentulous), fulfilling the inclusion and exclusion criteria. Completely edentulous subjects were divided into four groups (15 males and 15 females above 60 years) and (15 males and 15 females below 60 years). Dentulous group comprised 20 subjects (10 males and 10 females) between 41 and 75 years. After taking panoramic radiographs, vertical as well as horizontal reference lines were drawn. The parameters used for evaluation included mandibular cortical index (MCI), inferior mandibular cortical width (MCW), panoramic mandibular index (PMI), alveolar bone loss (ABL), and height of bone at first premolar (Hp) and first molar (Hm) of the mandible., Results: There was significant association between MCI and age for females with C2 and C3 categories being more common with advancing age. MCW was stable in all groups, except in females above 60 years of age. PMI and ABL were nonsignificant for age and gender. Although the average values of bone height (Hm and Hp) for males were higher than those of females, the results were statistically insignificant., Conclusion: Panoramic radiographic measurements could provide much valuable information and could help in evaluating patients with a low bone mineral density (BMD) with a few limitations., Clinical Significance: Dental professionals could screen the patients through panoramic radiographs taken during routine clinical examination, which could help in identifying patients with a low BMD so that further treatment could be initiated early and thus to prevent a pathologic fracture.

Haemophagocytic lymphohistiocytosis (HLH) is an aggressive syndrome which has characteristic symptoms and laboratory findings. Infection is a common trigger of HLH. We report a 2700 g male infant with persistent fever, massive hepatosplenomegaly and severe thrombocytopaenia. Laboratory evidence of primary dengue infection was detected. Investigations revealed hypertriglyceridaemia, hypofibrinogenaemia, hyperferritinaemia and elevated soluble CD25. Bone marrow examination revealed haemophagocytes. The diagnostic criteria for HLH were fulfilled. A diagnosis of secondary HLH triggered by primary dengue infection was considered. Dexamethasone was initiated and continued for 8 weeks. He responded clinically with regression of hepatosplenomegaly, was afebrile and platelet counts normalised. Dengue-associated HLH is often missed clinically as treating physicians focus more on the underlying infection and its treatment. In neonates, HLH should be considered as differential diagnosis of sepsis and other viral infections, particularly in situations of inappropriate response to standard management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Methylenetetrahydrofolate reductase (MTHFR) acts at an important metabolic point in the regulation of cellular methylation reaction. It assists in the conversion of 5, 10-methylenetetrahydrofolate to 5-methyltetrahydrofolate. The latter aids in remethylation of homocysteine to de novo methionine that is required for DNA synthesis. The objective of this study was to examine the effect of MTHFR 677 C>T polymorphism on the risk of breast cancer in the Indian sub-continent., Methods and Results: We genotyped 677 C>T locus in 1096 individuals that were classified into cases (N=588) and controls (N=508). Genotype data were analyzed using chi-square test. No significant difference was observed in the distribution of genotypes between cases and controls in north Indian (P = 0.932), south Indian (P = 0.865), and pooled data (P = 0.680). To develop a consensus regarding the impact of 677C>T polymorphism on breast cancer risk, we also conducted a meta-analysis on 28031 cases and 31880 controls that were pooled from sixty one studies. The overall summary estimate upon meta-analysis suggested no significant correlation between the 677C>T substitution and breast cancer in the dominant model (Fixed effect model: OR = 0.97, P=0.072, Random effects model: OR = 0.96, P = 0.084) or the recessive model (Fixed effect model: OR = 1.05, P = 0.089; Random effects model: OR= 1.08, P= 0.067)., Conclusion: 677 C>T substitution does not affect breast cancer risk in the Indo-European and Dravidian populations of India. Analysis on pooled data further ruled out association between the 677 C>T polymorphism and breast cancer. Therefore, 677 C>T substitution does not appear to influence the risk of breast cancer.

Introduction: TGF-β1 is a multi-functional cytokine that plays an important role in breast carcinogenesis. Critical role of TGF-β1 signaling in breast cancer progression is well documented. Some TGF-β1 polymorphisms influence its expression; however, their impact on breast cancer risk is not clear., Methods: We analyzed 1222 samples in a candidate gene-based genetic association study on two distantly located and ethnically divergent case-control groups of Indian women, followed by a population-based genetic epidemiology study analyzing these polymorphisms in other Indian populations. The c.29C>T (Pro10Leu, rs1982073 or rs1800470) and c.74G>C (Arg25Pro, rs1800471) polymorphisms in the TGF-β1 gene were analyzed using direct DNA sequencing, and peripheral level of TGF-β1 were measured by ELISA., Results: c.29C>T substitution increased breast cancer risk, irrespective of ethnicity and menopausal status. On the other hand, c.74G>C substitution reduced breast cancer risk significantly in the north Indian group (p = 0.0005) and only in the pre-menopausal women. The protective effect of c.74G>C polymorphism may be ethnicity-specific, as no association was seen in south Indian group. The polymorphic status of c.29C>T was comparable among Indo-Europeans, Dravidians, and Tibeto-Burmans. Interestingly, we found that Tibeto-Burmans lack polymorphism at c.74G>C locus as true for the Chinese populations. However, the Brahmins of Nepal (Indo-Europeans) showed polymorphism in 2.08% of alleles. Mean TGF-β1 was significantly elevated in patients in comparison to controls (p<0.001)., Conclusion: c.29C>T and c.74G>C polymorphisms in the TGF-β1 gene significantly affect breast cancer risk, which correlates with elevated TGF-β1 level in the patients. The c.29C>T locus is polymorphic across ethnically different populations, but c.74G>C locus is monomorphic in Tibeto-Burmans and polymorphic in other Indian populations.

Background: The geriatric population in India is increasing, and so is the prevalence of cancer. We aimed to study the knowledge, attitude and practices of end-of-life care issues of terminally ill geriatric cancer patients in our region., Methods: A pilot cross-sectional qualitative study using case studies, focus group discussions on providers and recipients of palliative care, an open-ended, interviewer administered questionnaire on specialist doctors and practitioners (50), geriatric cancer patients (20) and healthy family members of patients (30), was done in Lucknow, the capital of Uttar Pradesh, India., Results: Only 14 physicians (28%) could enumerate more than 3 important technical elements of end-of-life care. Two physicians (4%) utilized palliative care services but none had received training themselves. The explanations and counselling provided by physicians were mostly inadequate, incomplete and did not fully satisfy the patients and their relatives. Of the cancer patients, 19 (95%) desired to use special services but were unaware of such facilities. There was only one charitable organization for needy geriatric cancer patients in Lucknow. No specific health scheme existed in the programme of the Government of Uttar Pradesh., Conclusion: The knowledge and practices of physicians and specialists were not up to the expectations and requirements of terminally ill cancer patients. Curriculum-based learning or organized teaching of end-of-life care issues was non-existent. Western countries have well-organized subspecialty facilities for end-of-life needs; such facilities are lacking in India. Capacity building for the care of terminally ill geriatric cancer patients is urgently required in north India.

Dousa-hou is a Japanese psychological rehabilitation method which is widely used in Japan for children with mental retardation, cerebral palsy, and autism. The primary focus of the rehabilitation method is to improve bodily movements and posture as well as to introduce social support to patients and their first-degree relatives. Analysis showed mothers got more social support interacting with their child's trainer and supervisor during Dousa-hou. Trainers were more interactive than mothers in the Indian group, followed by the Japanese and Korean cultural groups.

This article highlights a range of design and analytical tools for studying the cross-cultural communication of emotion using forced-choice experimental designs. American, Indian, and Japanese participants judged facial expressions from all 3 cultures. A factorial experimental design is used, balanced n x n across cultures, to separate "absolute" cultural differences from "relational" effects characterizing the relationship between the emotion expressor and perceiver. Use of a response bias correction is illustrated for the tendency to endorse particular multiple-choice categories more often than others. Treating response bias also as an opportunity to gain insight into attributional style, the authors examined similarities and differences in response patterns across cultural groups. Finally, the authors examined patterns in the errors or confusions that participants make during emotion recognition and documented strong similarity across cultures.