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In India, the agriculture is main profession for more than sixty percent of the population. The stakeholders of agriculture in India, facing plenty of problems that leads the people of the country to shift their profession and lets them migrate towards urban area. So, need of implementing technology in agriculture is must in future days because as population is increasing in exponential form as the result huge requirement of food and agricultural product. The data analytics will play a significant role in agricultural dataset for implementing prediction and recommendation system in the sector. Yield is one of the factors to be considered in the agriculture that determines the wellness and prosperity of the farmer. In this paper deals with prediction system to predict yield of areca nut product in Puttur taluk, Dakshin Kannda District, Karnataka state in India. The time series data analytics model known as Auto Regressive Integrated Moving Average (ARIMA) model is used for yield prediction system. The research is mainly focused on forecasting of areca nut production for next four or five years in Puttur taluk. It compares various ARIMA models with performance criteria and selects best model for prediction purpose. The diagnostic check is carried out to test the system performance After the prediction, then the actual values and predicted values are compared and presented in the form graphical representation. [ABSTRACT FROM AUTHOR]

Background: Bronchial asthma is a serious public health problem throughout the world. The main feature of asthma is episodic airway obstruction. In India, as there are poor medical facilities or infrastructure, overcrowded hospitals where management to control asthma becomes very difficult. In this study an, attempt is made to study and implement these components of GINA, systematically in management of bronchial asthma. Methodology: This study was conducted on 50 patients more than age 18 years with Asthma. Patients with breathlessness who showed FEV1 reversibility were enrolled in the study. Each patient on baseline visit, one month after baseline visit, and at three months after baseline visit underwent SPIROMETRY AND PEFR test. All patients assessed for asthma as per GINA guidelines and categorised as uncontrolled, partially controlled and controlled. Patients who were in category uncontrolled as per GINA, treated with oral tablet. Results: Mean age was 37.70±9.40 years. 10(20%) patients were patients with controlled asthma, 30(60%) patients were partially controlled. 10(20%) patients were uncontrolled. Out of 10 uncontrolled patients 7(70%) patients became partially controlled and 3 patients remained as uncontrolled. At second visit, out of 10 uncontrolled patients, 7 patients (70%) become partially controlled, 2 (20%) patients become controlled and only one patient (10%) remained as uncontrolled (Chi Square test P=0.0000, Significant). Mean FEV1 was 73.94 % at baseline visit. On visit 1, it increased significantly by 4.2% from baseline visit. On visit 2, it increased significantly by 6.8% from baseline visit. The Mean PEFR was 241.40 L/min at baseline visit. On visit 1, it increased significantly by 6.5% from baseline visit. On visit 2 increased significantly by 13.5% from baseline visit. There were 13 smokers (26%) enrolled in this study,3 patients (23.1%) were controlled asthma,7 patients(53.8%) were partially controlled asthma and 3 patients (23.1%) were uncontrolled asthma. At the end of second visit 9 smokers (69.2%) were controlled, 4(30.8%) remained as partially controlled. None of smoker remained in uncontrolled group. Conclusion: Obese patients after weight reduction, smokers after quitting smoking, patients had good control of asthma. URTI and change in weather are commonest risk factors for bronchial asthma. After following GINA guidelines in management of bronchial asthma FEV1 and PEFR showed significant improvement and good control of asthma in most of the patients. Systematic approach in Diagnosis, management and prevention as per GINA guidelines can improve morbidity, reduce exacerbation and give patients good quality of life. [ABSTRACT FROM AUTHOR]

The world is currently facing a pandemic called COVID-19 which has drastically changed our human lifestyle, affecting it badly. The lifestyle and the thought processes of every individual have changed with the current situation. This situation was unpredictable, and it contains a lot of uncertainties. In this paper, the authors have attempted to predict and analyze the disease along with its related issues to determine the maximum number of infected people, the speed of spread, and most importantly, its evaluation using a model-based parameter estimation method. In this research the Susceptible-Infectious-Recovered model with different conditions has been used for the analysis of COVID-19. The effects of lockdown, the light switch method, and parameter variations like contact ratio and reproduction number are also analyzed. The authors have attempted to study and predict the lockdown effect, particularly in India in terms of infected and recovered numbers, which show substantial improvement. A disease-free endemic stability analysis using Lyapunov and LaSalle's method is presented, and novel methods such as the convalescent plasma method and the Who Acquires Infection From Whom method are also discussed, as they are considered to be useful in flattening the curve of COVID-19. [ABSTRACT FROM AUTHOR]

The changing paradigm of dental education in India has led its way to the development of Competency-Based Curriculum (CBC). This article describes the process of developing CBC in the specialty of Pediatric Dentistry under the initiative of Dental Council of India. Rationale behind CBC development is to bring uniform system of education for improving oral health outcomes of the society in long term. The process of CBC development was a collaborative teamwork, planned meticulously with predefined outline, tasks and timelines. Workflow involved identification of curricular content, defining program goals, outlining competencies, assigning them domains / levels of clinical competence, priority, educational strategies, assessment practices, integration and numbers needed for certification in selected competencies. Early clinical exposure was introduced in CBC. The final content was validated and submitted to the Council. CBC output can be summarized as competencies with fair share of all domains, levels, prioritization and integration. It is characterized by flexibility for choosing educational strategies and assessment practices. It opens up ways for global competition. However, it still has some inherent weaknesses like diverging learning paths, time constraints and number chasing. CBC can further have more academic flexibility and develop toward an outcome-based approach. Faculty preparedness and acceptability shall be the biggest challenges in CBC implementation besides resources' availability, support from leadership and acceptability from our primary stakeholders, our learners. CBC is the beginning of evidence-based delivery of education in dentistry. An effective implementation of CBC in current form would result in increased numbers of competent oral healthcare professionals for the society. [ABSTRACT FROM AUTHOR]

To address the wide variation in access to cancer care in India requires strengthening of infrastructure, trained oncology workforce, and minimisation of out-of-pocket expenditures. However, even with major investments, it is unlikely to achieve the same level of infrastructure and expertise across the country. Therefore, a resource stratified approach driven by evidence-based and contextualised clinical guidelines is the need of the hour. The National Cancer Grid has been at the forefront of delivery of standardised cancer care through several of its initiatives, including the resource-stratified guidelines. Development of new guidelines is resource and time intensive, which may not be feasible and can delay the implementation. Adaptation of the existing standard guidelines using the transparent and well-documented methodology with involvement of all stakeholders can be one of the most reasonable pathways. However, the adaptation should be done keeping in mind the context, resource availability, budget impact, investment needed for implementation and acceptability by clinicians, patients, policymakers, and other stakeholders. The present paper provides the framework for systematically developing guidelines through adaptation and contextualisation. The process can be used for other health conditions in resource-constraint settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Large river systems, such as the River Ganges (Ganga), provide crucial water resources for the environment and society, yet often face significant challenges associated with cumulative impacts arising from upstream environmental and anthropogenic influences. Understanding the complex dynamics of such systems remains a major challenge, especially given accelerating environmental stressors including climate change and urbanization, and due to limitations in data and process understanding across scales. An integrated approach is required which robustly enables the hydrogeochemical dynamics and underpinning processes impacting water quality in large river systems to be explored. Here we develop a systematic approach for improving the understanding of hydrogeochemical dynamics and processes in large river systems, and apply this to a longitudinal survey (> 2500 km) of the River Ganges (Ganga) and key tributaries in the Indo-Gangetic basin. This framework enables us to succinctly interpret downstream water quality trends in response to the underpinning processes controlling major element hydrogeochemistry across the basin, based on conceptual water source signatures and dynamics. Informed by a 2019 post-monsoonal survey of 81 river bank-side sampling locations, the spatial distribution of a suite of selected physico-chemical and inorganic parameters, combined with segmented linear regression, reveals minor and major downstream hydrogeochemical transitions. We use this information to identify five major hydrogeochemical zones, characterized, in part, by the inputs of key tributaries, urban and agricultural areas, and estuarine inputs near the Bay of Bengal. Dominant trends are further explored by investigating geochemical relationships (e.g. Na:Cl, Ca:Na, Mg:Na, Sr:Ca and NO 3 :Cl), and how water source signatures and dynamics are modified by key processes, to assess the relative importance of controls such as dilution, evaporation, water-rock interactions (including carbonate and silicate weathering) and anthropogenic inputs. Mixing/dilution between sources and water-rock interactions explain most regional trends in major ion chemistry, although localized controls plausibly linked to anthropogenic activities are also evident in some locations. Temporal and spatial representativeness of river bank-side sampling are considered by supplementary sampling across the river at selected locations and via comparison to historical records. Limitations of such large-scale longitudinal sampling programs are discussed, as well as approaches to address some of these inherent challenges. This approach brings new, systematic insight into the basin-wide controls on the dominant geochemistry of the River Ganga, and provides a framework for characterising dominant hydrogeochemical zones, processes and controls, with utility to be transferable to other large river systems., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

In India, there is increasing number of children with development delay and vision impairment with or without additional disabilities due to prematurity, brain damage, cerebral palsy, or genetic syndromes. Despite initiatives from Government of India, early intervention for these children remains a challenge across the country due to lack of trained professionals and appropriate resources. This paper describes the developmental screening tools, intervention aspects including Individualized Education Plan, procedures for handling children with cerebral visual impairment, team approach, and guidelines derived from the inputs of experts in vision rehabilitation centers of premier eye institutes in India.

Background: National surveillance conducted over 12 year period (2003 -2015) indicated that though the prevalence of HIV among Men having Sex with Men (MSM) has decreased in India, it is the second highest contributor in 2015. However, the prevalence of syphilis is an increase in the past 15 years. Under reach for screening; conscious hiding or withholding information due to stigma; limited resources and difficulty in screening vulnerable. Objective: The primary objective of the study is to explore the feasibility of using SNA for early identification of syphilis infection among MSM. Methodology: All MSM with newly identified syphilis infection in Chennai City during October and December 2015 were included in the study. A total of six samples were identified from the STI clinics lead by Government Hospitals in Chennai City, India and contact tracing at two levels (exponential snow-ball sampling method) were completed by the researcher. Unlike traditional screening program, the questionnaire used had indirect questions to avoid direct confrontation that helped to reach a total of 146 MSM during Jan to Oct 2016. Overall page ranking was completed for all MSM. All were followed up and encouraged to attend RTI/STI screening clinic through peers regularly. Results: 24 MSMs attended syphilis RPR screening test during this 10 months study period. 12 of 13 MSM were found to be positive for syphilis had page rank value of greater than one and 1 MSM had less than one page rank value. In the case of identified negative, all (n=11) except one MSM had page rank value less than one. Statistically, correlation of page ranking with syphilis reactive value showed a strong linear positive relationship (r = 0.732) with highly significance (p-value 0.000). Conclusion: This study proved that contact tracing and page ranking in SNA could be an effective measure to early identify syphilis infected MSM with its high positivity rate (54.2%). [ABSTRACT FROM AUTHOR]

Objective: A systematic approach is vital for adapting neuropsychological tests developed and validated in western monocultural, educated and English-speaking populations. However, rigorous and uniform methods are often not implemented during adaptation of neuropsychological tests and cognitive screening tools across different languages and cultures. This has serious clinical implications. Our group has adapted the Addenbrooke's Cognitive Examination (ACE) III for the Bengali speaking population in India. We have taken a 'culture-specific' approach to adaptation and illustrate this by describing the process of adapting the ACE III naming sub-test, with a focus on the process of selecting culturally appropriate and psychometrically reliable items Participants and Methods: Two studies were conducted in seven phases for adapting the ACE III naming test. Twenty-three items from the naming test in the English and the different Indian ACE-R versions were administered to healthy Bengali speaking literate adults to determine image agreement, naming and familiarity of the items. Eleven items were identified as outliers. We then included 16 culturally appropriate items that were semantically similar to the items in the selected ACE-R versions of which 3 were identified as outliers. The final corpus consisting of 24 items was administered to 30 patients with mild cognitive Impairment, Alzheimer's disease and vascular dementia, and 60 healthy controls matched for age and education to determine which items in the corpus best discriminated patients and the controls, and to examine their difficulty levels. Results: The ACE III Bengali naming test with an internal consistency of.76 included 12 psychometrically reliable, culturally relevant high naming-high familiarity and high naming-low familiarity living and non-living items. Item difficulty ranged from.47 to.88 and had discrimination indices >.44. Conclusions: A key question for test development/adaptation is whether to aim for culture-broad or culture-specific tests. Either way, a systematic approach to test adaption will increase the likelihood that a test is appropriate for the linguistic/cultural context in which it is intended to be used. Adaptation of neuropsychological tests based on a familiarity driven approach helps to reduce cultural bias at the content level. This coupled with appropriate item selection statistics helps to improve the validity of the adapted tests and ensure cross-cultural comparability of test scores both across and within nations. [ABSTRACT FROM AUTHOR]

The increased complexity in the current business environment connected with the globalisation of economies and rapid technological developments makes firms depend on innovation and, in the process, develop dense networks of relationships, making collaboration an essential requisite for innovation. Thus, collaboration develops based on complex social networks from which innovation emerges. From this perspective, collaboration takes a systematic approach, where social relationships are crucial. This article describes the innovation behaviour of firms operating in India and introduces collaboration as a system drawing from the systems theory and triple helix innovation model. The results of the mixed methods study conducted pointed toward a fragile collaboration framework. Triangulation was employed to provide a deeper understanding. Furthermore, limited understanding of collaboration as a social system has constrained social interactions, leading to limited knowledge production, application, and knowledge sharing, with technological development and innovation delays. The article lists crucial factors from the perspectives of industry and academia to foster a collaboration framework. [ABSTRACT FROM AUTHOR]

Rash and fever are some of the most common chief complaints present in paediatric dermatology emergencies. The spectrum of differential diagnosis is broad, including many different infectious and some non-infectious agents. A systematic approach involving detailed history taking, careful clinical examination along with particular attention to epidemiological features are the most important factors to make a diagnosis. This article reviews the morphological patterns of various causes of fever with rash in children, including infectious as well as non-infectious causes, with special emphasis on the Indian scenario. We intend to highlight the clinical characteristics of each cause, which will not only help make a clinical diagnosis but also distinguish benign versus life-threatening causes of skin rash in febrile paediatric patients and provide early medical intervention. [ABSTRACT FROM AUTHOR]

For decades, there has been ongoing discussion about whether centralized or decentralized wastewater management systems are better. Decision-makers need to define the best option but do not always have the necessary tools to develop, compare, and identify the most appropriate solution. To address this, studies have been conducted on a settlement level. In this study, the main focus was to develop and optimize wastewater management scenarios for a region containing rural areas, where data scarcity was an issue, by extracting scenario-relevant information from the region using a satellite image and its calibration using locally available data. We selected a study region in India containing 184 villages with a total population of around 210,000 and covering an area of around 400 km2. The study considered three different scenarios for the study area: centralized, decentralized, and an optimized scenario, which consists of a hybrid system involving partly decentralized and partly semi-centralized (clustered) infrastructure. The study developed a systematic approach for defining an optimized cluster of villages by considering the cost trade-off between the wastewater treatment plant (WWTP) capacity and sewer network layout. The results showed that the clustered and decentralized scenarios were nearly equal in terms of cost (around EUR 118 million), while the centralized scenario showed a relatively high cost of EUR 168 million. Potential applications and further development of the method were also considered. The proposed methodology may aid global wastewater management by estimating and optimizing infrastructure costs needed to fulfill Sustainable Development Goal 6 (SDG#6) in rural regions. [ABSTRACT FROM AUTHOR]

We all are aware of COVID 19 pandemic. As the numbers are increasing, the critical care demand is also increasing. Tracheostomy is one of the commonest procedures which has been performed on COVID positive ventilated patients. It is important to understand and follow the utmost safe practices for the patient and the health care workers for such aerosol generating procedures. The aim of this study is to identify the lacunae in tracheostomy practices during this COVID times and suggest a systematic approach for the safe practices. An online questionnaire survey-based study was performed in September 2020. The target population was practicing otolaryngologists of India with various years of experience. The aim of the study was to evaluate the lacunae in tracheostomy safe practices and to create a systematic approach for the safety of health care workers. Data compilation and analysis was done by using Microsoft Excel. A systematic COVID TIDE tracheostomy safe practices approach was designed after reviewing various tracheostomy guidelines and recommendations. Total 114 otolaryngologists responded with a complete survey report. 72.2% responders were not up to date with their knowledge of tracheostomy safe practices. 79.8% were not performing this procedure in a negative pressure room. 15.8% were not aware of the personal protective equipment level they are using. Only 56.1% survey responders were holding the ventilation before tracheal incision. Overall, 94.7% responders were keen to know about the safe approach of tracheostomy in COVID positive patients. Tracheostomy is an aerosol generating procedure, lacunae in the knowledge can cause major risk to health care professionals. Finally, in such crises, consideration should be taken for simulation exercises, dedicated airway teams and a systematic COVID TIDE approach to improve the safety of the staff and patients. [ABSTRACT FROM AUTHOR]

While rural 'Accredited Social Health Activists (ASHAs)' delivering primary care at the village-level in India experience high levels of work stress and burnout, little is known about the potential of positive psychology interventions in helping them respond to stressful situations. We aim to describe a systematic approach to designing and developing a 'character-strengths based' coaching program for rural ASHAs to help reduce their work-stress and improve their delivery of routine primary care. The development of the coaching program involved: (1) formative work, (2) blueprint development, (3) content development, (4) content-testing, and focus groups discussions to evaluate the feasibility and acceptability of the intervention, specifically the coaching workshop. This was followed by thematic qualitative analysis of ASHA perspectives/feedback to inform further modifications to the workshop. Intervention development occurred over 11 months, and the final coaching material consisted of a 'content manual' (for ASHAs) with four modules including character-strengths based 'strategies' to address challenges/stressors arising at health facilities, village communities and homes. Coaching material also included a workshop 'facilitator's manual' having session-wise detailed instructions, a list of 'energizers' and plans for the coaching workshop. Consistent efforts were made to tailor the case-examples and workshop activities (e.g., roleplays, videos and reflections or discussion-based activities) to the local culture and context. This study illustrates a step-wise approach to contextually adapt the evidence-based character-strengths intervention approaches with iterative feedback from stakeholders (ASHAs), to develop a face-to-face coaching program aiming to reduce work stress, tailored to the context of a rural low-resource setting. [ABSTRACT FROM AUTHOR]

The improper disposal of flower waste from cultural activities is one of the main challenges in certain countries such as India. If the flower waste is not managed properly, it causes a number of environmental issues. Therefore, various technologies have been developed to transform flower waste into value-added products. To integrate multiple technologies holistically to maximise the energy and material recovery, an integrated flower-waste biorefinery is required. Since there are a wide range of technologies available that can convert the waste into multiple products, there is a need to develop a systematic approach to evaluate all the technologies. This research proposes a systematic approach to synthesise an integrated flower-waste biorefinery based on different optimisation objectives, e.g., maximum economic performance and minimum environmental impact. Due to the conflicting nature between the two objectives, a fuzzy optimisation approach has been adapted to synthesise a sustainable integrated flower-waste biorefinery that satisfies both objectives at once. The efficacy of the proposed approach is demonstrated through a case study in India based on the optimised results with fuzzy optimisation—a synthesised flower-waste integrated biorefinery with economy performance of $400,932 and carbon emission of 46,209 kg CO2/h. [ABSTRACT FROM AUTHOR]

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Coastal aquaculture is an important economic activity in India dominated majorly by shrimp culture, which involves a range of interconnected processes that are challenging to analyse and optimise without a systematic approach. System dynamics modelling is a useful tool for understanding and predicting the behavior of complex coastal aquaculture systems. here, we review the status of dynamic simulation modelling works undertaken in aquaculture, which can provide directives for various researchers working on developing simulation models for shrimp aquaculture. There is a need to assess the impact of dynamic forces on the animals during the culture period which could be addressed through these models. System dynamic models assist decision-makers to augment potential measures for aquaculture-related problems under different possible scenarios. System dynamic models developed in aquaculture were related to feeding, water quality parameters, nitrogen dynamics, growth, etc. The strengths and limitations of software packages used in developing the simulation models are discussed. Considering the economic potential of shrimp aquaculture, it is important to develop an integrated dynamic model for predicting all the sub-processes of shrimp aquaculture. [ABSTRACT FROM AUTHOR]

Soil moisture plays a critical role in agricultural productivity and water resource management, especially in a diverse and populous country like India. Understanding variations in soil moisture across different regions and seasons is essential for adapting agricultural practices and water management strategies to local conditions. This study examines changes in soil moisture levels across India, comparing contemporary data from 2023 with historical averages from 2000 to 2005 using advanced remote sensing and GIS technologies. The primary objective of this study is to identify Soil Moisture Anomalies (SMA) across India, quantify their impacts on agriculture and water resources, and provide recommendations for targeted management strategies. By comparing recent soil moisture data against historical averages, the study aims to highlight trends and changes that could influence future water resource planning and agricultural practices. The research utilizes data from the Famine Early Warning Systems Network's (FEWS NET) i.e. Land Data Assimilation System (FLDAS), obtained from NASA's data archives. The study employs a systematic approach to analyze seasonal variations in soil moisture across different Indian states. Soil moisture levels were analyzed using zonal statistics in GIS to classify regions into categories based on the degree of anomaly observed. This classification helped in understanding the spatial distribution of soil moisture during the pre-monsoon, monsoon, and post-monsoon seasons. The study found significant regional and seasonal variations in soil moisture across India. During the monsoon period, areas such as Bihar and Jharkhand consistently showed significant moisture deficits, indicative of drought conditions, affecting agricultural output and necessitating urgent water conservation measures. Conversely, regions like Punjab benefited from positive soil moisture anomalies, enhancing agricultural productivity. The pre-monsoon and post-monsoon seasons also showed variations, with some areas experiencing deficits requiring careful water management while others had surpluses that increased the risk of flooding. The analysis of SMA in India underscores the need for region-specific agricultural and water management strategies that consider significant variability in soil moisture conditions. The study highlights the importance of integrating soil moisture monitoring into national policy frameworks to enhance climate resilience and sustainable agricultural practices. Future research should focus on updating soil moisture assessments with more recent data and refining predictive models to improve the accuracy and effectiveness of water management and agricultural interventions. [ABSTRACT FROM AUTHOR]

It is desirable that public health education institutions should ensure the placement of their students in relevant organisations by establishing placement systems and processes. This would help them to achieve the goal of enhancing public health through capacity building. The present study was conducted using survey design, and purposive sampling was used to contact institutions delivering postgraduate level public health education programmes in India. Eighty institutes across India were contacted, out of which 26 institutions participated in the study. The study identified placement initiatives undertaken by various institutions. Institutions are engaged in establishing placement cell; engaging faculty, students, alumni and external contacts in placement process; organising alumni meet and employers' meet, campus recruitment activities and are also involved in research related to placement. However, these initiatives need to be synchronised so as to effectively strategise the placements. In order to facilitate the placement of graduates effectively, public health education institutions should establish placement systems and processes. The first step in this regard can be creating standard operating procedures (SOPs), which can be referred to as a guiding document by the placement cell. The study brings value to the public health education institutions to adopt a systematic approach towards placement of its graduates. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is a looming pandemic, demanding prompt actions to avert catastrophic consequences. Effluents from pharmaceutical industries containing antimicrobial residues could serve as one of the entry points of these drugs to the environment. This qualitative study explores the treatment and disposal practices of pharmaceutical effluent (PE) containing potential antibiotic residues (ARs) by interviewing major stakeholders. In addition, we assessed their knowledge and perception on contribution of PE to AMR. Methods: The study was conducted in the two Indian states, Haryana and Telangana and at the federal level. Data was collected by semi-structured in-depth interviews of 29 participants from 17 stakeholders/organizations viz. Central Pollution Control Board (CPCB), State Pollution Control Boards (SPCBs) of Telangana and Haryana, civic body, pharmaceutical manufacturers, pharmaceutical associations and civil society. Data was analyzed using thematic analysis. Results: The effluent treatment and disposal practices varied with the multinational companies (MNCs) having advanced technologies whereas the small and medium-scale pharmaceutical companies (SMPCs) having effluent treatment plants as per the regulations but often under-utilized. The presence of ARs in the PE was considered inconsequential by SPCBs and SMPCs and majority of stakeholders imputed other causes as major contributors to AMR. However, the MNCs were well aware of the contribution of PE to AMR and CPCB also considered ARs as direct source of AMR. The central regulators as well as MNCs expressed concerns regarding the current regulations lacking maximum ARs in the PE. Conclusion: Setting up regulatory standards for maximum ARs in PE, their implementation and monitoring is an urgent need to curb environmental contribution of ARs to AMR. The findings of our study will help in systematic approach in policy making, awareness programs and capacity-building in dealing with the ARs in PE to combat AMR. [ABSTRACT FROM AUTHOR]

Efforts to reduce the global burden of common mental disorders have focused on scaling up evidence-based training programs for non-specialist providers to deliver brief psychological interventions. To evaluate these provider training programs, appropriate and scalable assessments of competency need to be developed alongside them. We followed a systematic approach for the cultural adaptation and translation into Hindi of a valid, English, multiple-choice applied knowledge measure to assess non-specialists' competence to deliver a brief psychological intervention for depression in rural India. We then explored the relationship between the performance of 30 non-specialist providers on the same written measure compared with a structured performance-based measure consisting of two role-plays. The results of the multiple-choice assessment had an overall mean score of 37.40 (SD = 11.31) compared to the mean scores of role-play A (the easier role-play) of 43.25 (SD = 14.50) and role-play B (the more difficult role-play) of 43.25 (SD = 13.00). Role-play performance-based measures and written applied knowledge measures represent different approaches with unique strengths and challenges to measuring competence. Scaling up training programs requires the development of scalable methods for competency assessment. Exploring the relationship between these two measures, our team found no apparent differences between the two modes of assessment. Continued comparison of these approaches is needed to determine the consistency of outcomes across the two formats and to link the scores on these measures with clinical performance as reflected by the quality of care and patient outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT04157816; 8th November 2019. [ABSTRACT FROM AUTHOR]

The ingested foreign body is one of the commonest emergencies encountered by otolaryngologists Depending on the shape and duration of impaction, a small number of foreign bodies (1–2%) can perforate the wall of the gastrointestinal Tract. A migrated foreign body may remain quiescent or cause life-threatening suppurative and vascular complications. Data were collected retrospectively from the hospital records in a tertiary care hospital in South India from 2010 to 2020. Fifteen patients diagnosed with migrated foreign body and who underwent neck exploration were included in the study. Demographic details, mode of presentation, clinical and radiological findings, rigid esophagoscopy findings, neck exploration techniques employed were noted. The mean age of the patients was 37.66 years. All patients had a history of dysphagia, odynophagia, and point tenderness. All the patients underwent a lateral neck radiograph, and it was positive in 12 patients (80%), while in 3 patients (20%), it was negative. All the patients had a positive finding in Contrast-Enhanced Computed Tomography. Esophagoscopy was done prior to neck exploration to identify the site of injury and the probable site of migration. All the patients underwent lateral neck exploration, and foreign body was removed. Migrated foreign body can cause significant morbidity and mortality if not diagnosed and managed early. Strong suspicion and a systematic approach are needed for the diagnosis and management. [ABSTRACT FROM AUTHOR]

Background: Multiple mhealth (mobile health) interventions and mobile applications have been developed to support diabetes self-management. However, most of the apps are developed without the need for assessment and evaluation by experts in the field. This study aimed to design and develop a mobile application (app) supporting diabetes self-management for people with Type 2 Diabetes Mellitus (T2D) using a systematic approach. Methods: In this study mixed method design was used to develop the mobile application. The mhealth intervention was designed and developed in five steps: i) Extensive literature search, ii) Needs assessment of patients with T2D with the help of healthcare providers and patients (Interviews with 15 healthcare providers like clinicians, dietitians, and diabetes educators, and 2 focus group discussions with patients) iii) Ideation and content development of app based on outcomes of needs assessment; iv) content validation (by 10 healthcare providers) and v) App development on a hybrid platform. Evaluation of the app by users i.e., type 2 diabetes patients was done using the users' Mobile App rating scale (uMARS). The app was evaluated by 40 patients and rated on the uMARS questionnaire. Results: A patient-centric mobile app was developed for the nutritional management of diabetes with three modules: The patient module, the Evaluation module, and the Healthcare provider module. The patient module was the app that was provided to the patients with features like diet, physical activity, blood glucose log, education, etc., in addition to, a symptom checker, Stress meter blog, and FAQ. The evaluation module was integrated with the app it works when a user enters any log, it evaluates the entry against the standard cutoffs and flash prompts on the screen. The Healthcare provider module interacts with the server to provide them with patient data, comments, and feedback. Conclusions: The users found the app to be satisfactory. Incorporating additional features to enhance the user interface and streamline navigation could potentially enhance user engagement, thereby aiding in the management of T2D. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Disorders of sodium and water metabolism are frequently encountered in patients admitted to the Intensive Care Unit (ICU), and may even be acquired there. A systematic approach is needed to evaluate the causes of hyponatremia for better patient care. MATERIAL AND METHODS: 100 adult patients with admission serum sodium levels <135 mEq/L in the ICU were recruited for this study over 18 months. Through history taking and appropriate laboratory investigations, the prevalence, causes, morbidity and mortality of hyponatremia were assessed. Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was diagnosed using Schwartz and Bartter clinical criterion. RESULTS: 23 cases were deemed to have pseudohyponatremia likely caused by dyslipidemia or hyperproteinemia, whereas remaining 77 cases had true hyponatremia. Values of arterial and venous sodium have a positive correlation indicating agreement between the parameters. Majority of subjects were males (61%). Causes of hyponatremia include: neurological causes in 34 cases (44.2%), followed by gastrointestinal cause 18 cases (23.4%), respiratory cause 15 cases (19.5%), cardiac cause 5 cases (6.5%), and other causes 5 cases (6.5%). Most frequently encountered diagnosis included cerebrovascular accident (16 cases), pneumonia (10 cases), metabolic encephalopathy (10 cases), acute gastroenteritis (8 cases) and tubercular meningitis (6 cases). Of 77 cases studied, 18 cases (23.4%) had hypovolemic hyponatremia (due to acute gastroenteritis), 51 cases (66.2%) had euvolemic hyponatremia (due to SIADH, likely caused by cerebrovascular accident, pneumonia or metabolic encephalopathy) and 8 cases (10.4%) had hypervolemic hyponatremia (due to chronic renal failure or congestive cardiac failure). Mortality in this population was 11.7%, and was seen mainly in patients of severe hyponatremia. CONCLUSIONS: Severity of hyponatremia, male gender and neurological symptoms correlated significantly with morbidity and mortality in this cohort and the information from this study can be used to better identify patients at risk of adverse outcomes due to hyponatremia in critical care setting. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 pandemic adversely affected the essential care of newborns. In a tertiary care hospital in India, all COVID‐19 suspect post‐natal mothers awaiting COVID results were transferred to a ward shared with symptomatic COVID suspect female patients from other clinical specialities, due to shortage of space and functional health workforce. Babies born to COVID‐19 suspect mothers were moved to a separate ward with a caretaker until their mothers tested negative. Due to shortage of beds and delay in receiving COVID results, mothers and babies were often discharged separately 2–3 days apart to their home. This deprived babies of their mother's milk and bonding. We, therefore, undertook a quality improvement (QI) initiative aiming to improve rooming‐in of eligible COVID‐19 suspect mother–newborn dyads from 0% to more than 90% over a period of 6 weeks. Methods: A QI team was formed which ran multiple Plan‐Do‐Study‐Act cycles. The results were reviewed at regular intervals and interventions were adopted, adapted or abandoned. These included advocacy, rearrangement of wards, counselling of mothers and caretakers regarding infection prevention practices and coordination between labour room, post‐natal ward and nursery staff. Results: An improvement in rooming‐in from 0% to more than 90% was achieved. Conclusion: QI methodology is a systematic approach in addressing and solving unexpected unforeseen problems effectively. [ABSTRACT FROM AUTHOR]

Background: Depression poses a major public health burden and has a large treatment gap in India. The study attempts to address this treatment gap by developing a training video for Accredited Social Health Activists (ASHAs), who are community health workers, on brief psychological intervention for depression. Methods: The systematic steps utilized in the design and development of the training video on depression were: 1) Content development of the video script and training booklet for ASHAs based on the review of research literature and two Focus Group Discussions, 2) Mental Health Professionals’ evaluation of the video script and training booklet for ASHAs, 3) Translation from English to Kannada, 4) ASHAs’ evaluation of the video script and training booklet for ASHAs, 5) Conversion of the video script into a ‘shooting script’, 6) Video production, 7) Evaluation of the training video, 8) Post‑production of the training video, and 9) Development of the training guide. Results: The training video titled “Light of Hope: A Training Video on Depression” was developed along with two training booklets, which are complementary resource materials, for ASHAs and the training Facilitators. The brief psychological intervention for depression elucidated in the training video incorporates the evidence‑based strategies of Psychoeducation, Activity Scheduling, Problem‑Solving Skills Training, and Diaphragmatic/Abdominal Breathing Skills Training. Conclusion: The study demonstrates the systematic approach that can be employed for the design and development of a mental health training video, which has evidence‑based content, incorporates stakeholders’ evaluative perspectives, and is culturally contextualized. [ABSTRACT FROM AUTHOR]

Miliary tuberculosis or disseminated tuberculosis is one of India's most typical forms of tuberculosis. It can have varied presentations, from classical pulmonary disease to affection of extra-pulmonary sites, the most common being the vertebral column. With a wide array of clinical manifestations, differentiating disseminated tuberculosis from common malignancies is no less than a herculean task for a clinician. Keeping a high index of clinical suspicion and detailed work up in the right direction can save the clinician and the patient from an exhaustive ordeal of futile investigations. Here, we present a rare case of miliary tuberculosis masquerading as a common malignancy of the elderly, reemphasizing the need for a systematic approach to such confusing presentations. [ABSTRACT FROM AUTHOR]

Estimated deaths rate due to snake bites are more than 46,000 annually in our country. Ninety-seven to ninety eight percent bites occur in rural or remote areas. Snake bite is a one of common problem faced in rural India. It takes a high toll of lives mainly of working male of the family. The current prospective observational study was carried out to study the clinical and management by systematic approach of snake bites. The 245 cases of snake bite were hospitalized to Rural Hospital in a period of July 2017 to June 2018. The present data showed that majority (91.43%) of cases were encountered from rural area,in the age group ranging from 21 to 30years (24.90%) Majority were male patients (62.04%). Most affected were the agricultural laborers and farmers (56.33%). 60.82% of the cases were presented with bite over lower extremities .Most of the snake bite (75.97%) occurred during day time. July to October was the period in which most snake bite cases were observed. It was seen that syndromic or systematic approach was more effective in early diagnosis and treatment of snake bite. The average requirement of anti- serum venom (ASV) required for cobra bite was 16,krait bite 22,Russell's viper bite 12 and saw scaled viper bite 10. The total duration of treatment in hospital for cobra bite were 6, krait bite 8, Russell's viper bite 4 and saw scaled viper 4 days. [ABSTRACT FROM AUTHOR]

Lean manufacturing (LM) applies different tools that help to eliminate waste as well as the operations that do not add value to the product or processes to increase the value of each performed activity. Here the main motivation is to study how quantitative modelling approaches can support LM tools even under system and environment uncertainties. The main contributions of the article are: (i) providing a systematic literature review of 99 works related to the modelling of uncertainty in LM environments; (ii) proposing a methodology to classify the reviewed works; (iii) classifying LM works under uncertainty; and (iv) identify quantitative models and their solution to deal with uncertainty in LM environments by identifying the main variables involved. Hence this article provides a conceptual framework for future LM quantitative modelling under uncertainty as a guide for academics, researchers and industrial practitioners. The main findings identify that LM under uncertainty has been empirically investigated mainly in the US, India and the UK in the automotive and aerospace manufacturing sectors using analytical and simulation models to minimise time and cost. Value stream mapping (VSM) and just in time (JIT) are the most used LM techniques to reduce waste in a context of system uncertainty. [ABSTRACT FROM AUTHOR]

Telemedicine has been a buzzword in India since the 1990s. In 2020, due to the COVID-19 pandemic in India, a national lockdown limited access to in-person healthcare services. The Ministry of Health & Family Welfare issued India's first set of government guidelines for the use of telemedicine. Emphasis was placed on training doctors and gearing up teleconsultations. This effort led to a significant increase in consultations and the recruitment of additional clinicians to practice telemedicine. However, there remain challenges relating to privacy, patient data storage, unevenness in telecom infrastructure and a systematic approach to integrating teleconsultation data with the overall patient record and public health information systems. This paper will provide an overview of telehealth, examine key interventions that have occurred in India during the pandemic and explore potential future approaches that can leverage the benefits of telehealth across the health care spectrum. [ABSTRACT FROM AUTHOR]

Background: Aesthetic correction involves a holistic approach which considers the oral cavity as a whole by the norms of the treatment. Aesthetics enhance the facial profile and also the smile line of the patient which improves the quality of life of a patient enabling them to a better socioeconomic status. Smile correction of a patient paves the path for a systematic approach to the treatment and also imparts an improved level of confidence which leads to new opportunities both in the personal and professional field. AeEsthetic correction provides challenging aspects concerning patient satisfaction and functional demands. This is the most affordable treatment for patients' who are not financially sound in developing countries like India. The other treatment modalities such as Veneers or All-ceramic crowns are aesthetically pleasing but are quite expensive for people in the lower income strata. Due to this, direct composite treatment is very economical and it also improves the patient's overall confidence and it helps them to socialise well and carry out their daily routine activities without any hindrance and difficulty. Case Report: This case report deals with the esthetic correction of midline diastema and spacing in the maxillary and mandibular anterior region. Conclusion: Aesthetic correction involves meticulous treatment planning to revive the essence of lost beauty as well as improve the functional aspect for the patient. [ABSTRACT FROM AUTHOR]

Make in India is a term created by Prime Minister Narendra Modi on 25 September 2014 to encourage businesses all over the world to invest, and manufacture their products, in India. India should take a systematic approach to manufacturing evaluations in order to gain a competitive edge and develop global leadership. 'Make in India' is a government-led programme aimed at encouraging international and domestic companies to produce their products in India. The major purpose of the project is to focus on job creation and skill development. Domestic investment must take the lead, as foreign direct investment (FDI) accounts for less than 8% of overall investment in the country. The purpose of the research is to examine the impact of the 'Make in India' policy on FDI inflows and to investigate the potential of 'Make in India'. When the average FDI inflow was compared before and after the 'Make in India' period, the results revealed a significant difference. This suggests that the average FDI inflow of the period after 'Make in India' is greater than that of the period preceding it. However, there hasn't been much of a difference in FDI inflows as a percentage of GDP, implying that FDI inflows as a percentage of GDP haven't increased considerably and that more attention is needed. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) in India and globally are the major cause of mortality, as revealed by the World Health Organization (WHO). The irregularities in the pace of heartbeats, called cardiac arrhythmias or heart arrhythmias, are one of the commonly diagnosed CVDs caused by ischemic heart disease, hypertension, alcohol intake, and stressful lifestyle. Other than the listed CVDs, the abnormality in the cardiac rhythm caused by the long term mental stress (stimulated by Autonomic Nervous System (ANS)) is a challenging issue for researchers. Early detection of cardiac arrhythmias through automatic electronic techniques is an important research field since the invention of electrocardiogram (ECG or EKG) and advanced machine learning algorithms. ECG (EKG) provides the record of variations in electrical activity associated with the cardiac cycle, used by cardiologists and researchers as a gold standard to study the heart function. The present work is aimed to provide an extensive survey of work done by researchers in the area of automated ECG analysis and classification of regular & irregular classes of heartbeats by conventional and modern artificial intelligence (AI) methods. The artificial intelligence (AI) based methods have emerged popularly during the last decade for the automatic and early diagnosis of clinical symptoms of arrhythmias. In this work, the literature is explored for the last two decades to review the performance of AI and other computer-based techniques to analyze the ECG signals for the prediction of cardiac (heart rhythm) disorders. The existing ECG feature extraction techniques and machine learning (ML) methods used for ECG signal analysis and classification are compared using the performance metrics like specificity, sensitivity, accuracy, positive predictivity value, etc. Some popular AI methods, which include, artificial neural networks (ANN), Fuzzy logic systems, and other machine learning algorithms (support vector machines (SVM), k-nearest neighbor (KNN), etc.) are considered in this review work for the applications of cardiac arrhythmia classification. The popular ECG databases available publicly to evaluate the classification accuracy of the classifier are also mentioned. The aim is to provide the reader, the prerequisites, the methods used in the last two decades, and the systematic approach, all at one place to further purse a research work in the area of cardiovascular abnormalities detection using the ECG signal. As a contribution to the current work, future challenges for real-time remote ECG acquisition and analysis using the emerging technologies like wireless body sensor network (WBSN) and the internet of things (IoT) are identified. [ABSTRACT FROM AUTHOR]

Aadhar card is an Indian Government ID card that is issued to all Indian residents. It is one of the largest biometric databases in the world with over 1.28 billion enrollments thereby constituting the most ubiquitous ID card in India. With the additional features of QR code and biometric scanning, it forms an ideal database to be linked with the electronic health record. The health records of an individual currently in India is being maintained by the individuals. But most often they are misplaced, disorganized, incomplete or lost. This would force the clinician to assume or ascertain the current medical status by subjecting the individual to tests. Improving the quality of the medical and dental services rendered paves way for an integrated electronic health record. The common concerns arising from such a linkage is data management and data security. Big data management provides a systematic approach to maintaining such large data. The data security concerns can be addressed by employing a data controller in every hospital and a cell to inform the security breach, who can further take up legal penalties. Pseudonymisation, cryptography, audit trial, firewall, antivirus software, and cloud computing are some techniques that can be incorporated. [ABSTRACT FROM AUTHOR]

India is that the second-largest populated country within the world. Of the total population, nearly 47.9% constitute a deprived society. The Indian Government is trying its best to uplift the deprived society. To help the person who falls below the povert y line, the Government has launched a scheme known as the National Social Assistance Programme. This scheme was introduced in the year 1995 with three schemes that are National Old Age Pension Scheme, National Family Benefit Scheme and National Maternity Benefit Scheme. At present, National Social Assistance Programme (NSAP) consists of 5 schemes that are Indira Gandhi National Old Age Pension Scheme (IGNOAPS), Gandhi National Widow Pension Scheme (IGNWPS), Indira Gandhi National Disability Pension Scheme (IGNDPS), National Family Benefit Scheme (NFBS) and Annapurna Scheme. Firstly, the life expectancy rate is increasing which increased the elderly population which covers about 8.5% of the total population; to help those IGNOAPS was introduced. Secondly, the IGNWPS was introduced to help the widows who constitute around 10% of the total population. Thirdly, IGNDPS was introduced which covers the disabled persons accounting for 2.21% of the total population. Fourthly, to help the family members who lost their breadwinner, NFBS was launched. Lastly, Annapurna Scheme was introduced to cover the elderly population who were eligible under IGNOAPS but are unable to get pension were given food grains free of cost. An attempt has been made in this paper to analyses al l the five schemes under the NSAP and longing for the improvement, effective implementation mechanism and a unified and systematic approach helped by the direct bank transfer. The present study has been conceptually made to understand the acceptability of all the five schemes of NSAP and its contribution to increasing the socio-economic status of the beneficiaries. [ABSTRACT FROM AUTHOR]

Big data analytics involve a systematic approach to find hidden patterns to help the organization grow from large volume and variety of data. In recent years big data analytics is widely used in the agricultural domain to improve yield. Viticulture (the cultivation of grapes) is one of the most lucrative farming in India. It is a subdivision of horticulture and is the study of wine growing. The demand for Indian Wine is increasing at about 27% each year since the 21st century and thus more and more ways are being developed to improve the quality and quantity of the wine products. In this paper, we focus on a specific agricultural practice as viticulture. Weather forecasting and disease detection are the two main research areas in precision viticulture. Leaf disease detection as a part of plant pathology is the key research area in this paper. It can be applied on vineyards of India where farmers are bereft of the latest technologies. Proposed system architecture comprises four modules: Data collection, data preprocessing, classification and visualization. Database module involves grape leaf dataset, consists of healthy images combined with disease leaves such as Black measles, Black rot, and Leaf blight. Models have been implemented on Apache Hadoop using map reduce programming framework. It applies feature extraction to extract various features of the live images and classification algorithm with reduced computational complexity. Gray Level Co-occurrence Matrix (GLCM) followed by K-Nearest Neighborhood (KNN) algorithm. The system also recommends the necessary steps and remedies that the viticulturists can take to assure that the grapes can be salvaged at the right time and in the right manner based on classification results. The overall system will help Indian viticulturists to improve the harvesting process. Accuracy of the model is 82%, and it can be increased as a future work by including deep learning with time-series grape leaf images. [ABSTRACT FROM AUTHOR]

Rationale: Bear mauling is the most common wild animal-inflicted injury in India. Ideally, these injuries should be managed early with fracture fixation, wound debridement, and appropriate coverage. Delay may lead to devascularization and a more severe deformity, which needs complex and multi-staged procedures for optimal outcome. Patient Concerns: Facial deformity in bear mauling is upsetting to the patient. Apart from facial aesthetics, the victim has difficulties in speech, eating, and respiration when the midface is involved. Diagnosis and Treatment: Patients require proper assessment of the soft tissue and bony defects by clinical assessment and imaging before planning any reconstruction. Outcome: The complex defect was managed in stages by both microsurgical and nonmicrosurgical methods including debridement, fracture fixation, local flaps, free flap, and prosthesis. Take-away Lessons: Systematic approach in categorizing each component of the problem, finding the best possible solution for each of them, and inter-departmental collaboration are important. [ABSTRACT FROM AUTHOR]

Primary health care is a vital component in health care delivery. Non-communicable diseases (NCD's) are rising like a major threat to human survival, which is expected to account for 75% of the total mortality by 2030. Lifestyle and behavioural changes are reckoned as the way ahead. Yoga and Naturopathy, a drugless system of medicine has intersecting paradigms which addresses all planes of health effectively. Yoga and Naturopathy through its holistic approach educate and make the people responsible for their own health. It has shown its efficacy in alleviating and preventing various NCD's. A systematic approach should be initiated, which can channelize the integration of Yoga and Naturopathy at the primary care level considering its cost-effectiveness and efficacy over NCD's. [ABSTRACT FROM AUTHOR]

Background: Pancytopenia is characterized by decreased hemoglobin (adult males <13 g/dl, pregnant females <10 g/dl, nonpregnant females and children <11 g/dl), total leukocyte count (<4 × 109/L), and platelet count (<100 × 109/L). Depending on the severity, patients can present with varied symptoms. Vast majority of conditions causing pancytopenia are known. Hence, a systematic approach is a mandatory requirement to identify the cause of pancytopenia for appropriate management. Aim: Clinicopathological study of new onset pancytopenia and to determine the frequency of different etiologies causing pancytopenia. Materials and Methods: A prospective study of 451 consecutive cases who had pancytopenia and presented in outpatient or emergency room of a tertiary care center of Western India, from July 2017 to September 2019. The clinical data of the patients were obtained and hematological investigations were analyzed in the hematopathology section of the pathology department. Bone marrow (BM) aspirates and biopsies were performed in 355 cases. Data were analyzed using SPSS software. Results: Patients age ranged from 6 months to 84 years with mean standard deviation of 45.89 ± 19.21 years. Overall male to female ratio was 1.87:1. Hematolymphoid malignancy was the most common cause (n = 137, 30.37%) followed by nutritional anemia (n = 97, 21.5%), infections (n = 68, 15.07%), BM failure (n = 66, 14.63%), hypersplenism (n = 55, 12.19%), and autoimmune disorder (n = 11, 2.44%). Conclusion: Pancytopenia is a common hematological entity with the multifactorial etiologies. It can present as a life-threatening condition or can be merely transient. Hematolymphoid malignancy was found to be the most common underlying cause in our study. An accurate etiological break will further assist in appropriate management of these patients. [ABSTRACT FROM AUTHOR]

Educational technology designs in developing countries mostly focus on making knowledge resources widely available, through MOOCs, repositories and computer‐based tutoring. The use of digital media for cognitive augmentation, particularly interactive designs that help learners understand modelling topics in STEM, is underexplored. We report a 3‐year design study examining this potential in the Indian context, testing two iterations of an interactive system, Touchy‐Feely Vectors (TFV). The design supports learning vectors, a modelling topic pre‐university students struggle with. Virtual lesson‐plans were co‐designed with teachers to augment — but not replace — their existing practices, and to address classroom and resource constraints. Pre‐post testing of TFV‐1 (a computer‐based prototype) showed that it helped students develop a more integrated vector concept, and improved their reasoning. Field‐implementation of TFV‐2 (a textbook‐linked touch‐screen based design) in 6‐classrooms (3‐Control, N=135; 3‐Experimental, N=131) showed that it fostered cognitive engagement in average‐students and geometry‐algebra integration (model‐based reasoning) in good‐students. These results, along with a requirements analysis based on textbooks, indicate that the interaction possibilities supported by different representational media critically shape student reasoning. The study also illustrates a systematic approach to design and test digital media systems that support cognitive augmentation in developing countries. Lay description: What is already known about this topic: Computational modelling is central to model‐based reasoning (MBR) in contemporary scientific practice. Education needs to change to support this new way of thinking. However, it is not clear how this could be done systematically in developing countries.Textbooks are thus not replaceable in developing nation contexts, and any digital media designed to help develop model‐based reasoning in students would need to work with textbooks and existing teaching/learning practice. It is unclear how this could be done.When learning basic model‐based reasoning using static textbook media, students struggle with core MBR topics like vectors. What this paper adds: The paper reports a 3‐year design‐based study, where a vector simulation system was developed (Touchy‐Feely Vectors), which addressed the following issues. Addressing 2 above, the study illustrates a design that builds on static textbook media and associated practices.Addressing 3 above, a 2‐phase field test of the design (N = 266) showed that the system changes student reasoning, towards better integration of algebra and geometry, while reasoning with vectors.Addressing 1 above, the study provides a new model to implement the learning of modelling using interactive simulations, in developing country classrooms.Addressing 1 above, the study offers a clear model for designing such interventions in developing country contexts.More broadly, the study reveals how the nature of the medium used to present science content changes student cognition and reasoning. Implications for practice and/or policy: For curricula: The design we present can be extended easily, to develop similar systems for other topics. The design also illustrates how teachers adopt technology when they participate in the design.For policy: This design provides a workable policy alternative to the costly model of the digital medium replacing current media and its teaching/learning practices.For Research and Pedagogy: Our results suggest that researchers and teachers need to examine the capabilities and constraints of different media while analysing learning difficulties, and develop ways to address these issues [ABSTRACT FROM AUTHOR]

Intensification of agriculture has challenged environmental sustainability in the form of contaminated water resources, particularly due to the irrational use of synthetic fertilizers. The strong relationship between yield and fertilizer use has led farmers to overrule the systematic approach of fertilizer application. Although various measures have been applied to understand the farmers' decision-making regarding fertilizer application rates, its excessive use, however, remains inexplicable. To understand this decision-making process, the study attempts to assess the farmers' fertilizer use behaviour using a socio-psychological model based on available resources, prevailing socio-economic conditions and personal aspects of users in Uttar Pradesh region of India. A survey study was conducted on 312 farmers, categorized by differential land holdings. Regression analysis results indicated that among the series of variables, variables, viz. lack of eco-efficient fertilizers, access to irrigation, credit facilities, use of available cash, farming experience and farm size, are critical ones for determining the fertilizer use decision of farmers. The outcome of the study argues that sustainable interventions in agriculture facilitate the management of natural resource base as global consequences of over-consumption of nitrogen fertilizer particularly have challenged the capacity of natural resources, viz. soil and water. This research work suggests the need for site-specific tailor-made policy measures which can be instrumental in mitigating environmental externality resulting from mismanaged farm practices like excessive use of fertilizers. [ABSTRACT FROM AUTHOR]

Objectives: To present the clinical profile, diagnostic work-up, and management of children with Disorders of Sexual Development (DSD).Materials and Methods: A retrospective study from a tertiary pediatric endocrine unit of western India. We included 39 patients who presented over a period of 9 years from June 2009 to June 2018. Results: Nineteen patients (48.7%) were diagnosed with 46 XY DSD, 16 (41%) with 46 XX DSD, and 4 (10.3%) with sex chromosomal DSD. Out of 46 XY DSD, androgen insensitivity was observed in 8 (42.1%) patients, 5 alpha-reductase deficiency in 5 (26.3%), gonadal dysgenesis in 3 (15.8%), ovotesticular DSD in 2 (10.5%) and 17 beta-hydroxylase (17γ-HSD3) deficiency in 1 (5.3%). Congenital adrenal hyperplasia was the most common cause in 46 XX DSD observed in 11 (68.75%) out of 16 patients, ovotesticular DSD was seen in 4 (25%) patients and testicular DSD in 1 (6.25%) patient. In sex chromosomal DSD 3 (75%) patients had mixed gonadal dysgenesis and 1 (25%) had ovotesticular DSD out of a total of 4 patients. At presentation gender of rearing was assigned as male in 16 (41%) patients, female in 20 (51.3%) patients, and no gender was assigned in 3 (7.7%). The gender of rearing was changed after diagnosis in 6 (16.7%) children. Conclusion: CAH was the most common etiology of 46 XX DSD whereas androgen insensitivity among 46 XY DSD. Assigning the sex of rearing should not be hurried and should be done only after diagnosis and parental counseling. A multidisciplinary and systematic approach is required for children with DSD. [ABSTRACT FROM AUTHOR]

Groundwater in India plays an important role to support livelihoods and maintain ecosystems and the present rate of depletion of groundwater resources poses a serious threat to water security. Yet, the sensitivity of the hydrological processes governing groundwater recharge to climate variability remains unclear in the region. Here we assess the groundwater sensitivity (precipitation–recharge relationship) and its potential resilience towards climatic variability over peninsular India using a conceptual water balance model and a convex model, respectively in 54 catchments over peninsular India. Based on the model performance using a comprehensive approach (Nash Sutcliffe Efficiency [NSE], bias and variability), 24 out of 54 catchments are selected for assessment of groundwater sensitivity and its resilience. Further, a systematic approach is used to understand the changes in resilience on a temporal scale based upon the convex model and principle of critical slowing down theory. The results of the study indicate that the catchments with higher mean groundwater sensitivity (GWS) encompass high variability in GWS over the period (1988–2011), thus indicating the associated vulnerability towards hydroclimatic disturbances. Moreover, it was found that the catchments pertaining to a lower magnitude of mean resilience index incorporates a high variability in resilience index over the period (1993–2007), clearly illustrating the inherent vulnerability of these catchments. The resilience of groundwater towards climatic variability and hydroclimatic disturbances that is revealed by groundwater sensitivity is essential to understand the future impacts of changing climate on groundwater and can further facilitate effective adaptation strategies. [ABSTRACT FROM AUTHOR]

This article presents a methodology to find out a suitable ocean wave energy converter (OWEC) device for Indian coastal region. A comprehensive literature survey of all the existing OWEC devices is done and thereafter, 13 OWEC devices are shortlisted on the basis of Indian coastal wave power flux density. A systematic approach is used to predict unknown quantities such as: total annual cost per MW, system overall efficiency and relative impact on surrounding. List of the selected devices is narrowed down based on total annual cost per MW, efficiency and effect on surrounding environment. The proposed analysis concluded that cost-effective OWEC devices which are efficient as well as eco-friendly are L1-L3 (Sweden), and SSG (Norway) for Indian coast. A similar approach can also be applied to predict a suitable OWEC device for other regions. [ABSTRACT FROM AUTHOR]

Women in India are playing a crucial role in protection and conservation of environment. Women in our country have brought a different perspective to the environment debate, because of their different experience base. In India about approximately 96% of rural household are estimated to be using bio fuels. One of the important features of rural energy is the dependence on locally available biomass resources. Fuel wood is the primary energy source for cooking used by rural households. Mostly village women spent 3 to 6 hr a day for collection of fuel wood. They understand clearly that economics and environment are compatible. Their experience reveals to them that soil, water and vegetation, necessary for their day-today living, requires care and good management. Environmental degradation is related not only to the biosphere alone, but to the social sphere as well. Women are also the active members of most of the community forests. women are providing an important role in sustainable development of community forests. However, their role is neither properly identified nor explored. A study was done in remote villages of central Chhattisgarh, India to examine the relationship between fuel consumption pattern and certain influencing factors. To formulate a systematic approach for studying about women's participation an elaborate exercise was taken for data collection. It was observed that enhanced use of alternative sources of energy can balance the increasing demand of fuel wood and make use of fuel more economic. Utilization of non conventional sources of energy as solar cooker and bio gas and energy saving devices, promotion of the fuel wood plantation system near the villages not only reduce the biotic pressure from vegetation but also promote the green cover which could support the environment. This paper explores and analyzes women's role in development and conservation of forest for through sustainable energy management. [ABSTRACT FROM AUTHOR]

Background: Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate.Aims: To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare.Method: The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment.Results: The Healthy Activity Program (HAP) is delivered over 6-8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32-0.94,P= 0.01).Conclusions: Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care. [ABSTRACT FROM AUTHOR]

Background: Silicosis remains a major occupational health challenge in India. This review systematically examines the prevalence, risk factors, regional differences, and diagnostic tools specific to India's high-risk industries. Additionally, it assesses policy gaps and offers insights from diverse clinical and qualitative studies, aiming to inform targeted public health interventions and support the development of effective occupational health policies. Methods: For this review, data were extracted for each study, including author, location, design, study aims, sample size and characteristics, participant age, duration of silica exposure, diagnostic criteria, and primary outcomes. As an add-on analysis included, a random-effects meta-analysis was used to estimate the pooled prevalence of silicosis and assess variability among studies. The review also included qualitative analyses on awareness, diagnostic tools (e.g., CC16 protein), and differences in prevalence across various occupational groups and regions within India. Results: The review initially identified 263 articles, narrowed down to 49 eligible studies on silicosis in India after exclusions and quality assessment. Among these, 11 prevalence studies (total sample size: 2072) showed an average silicosis rate of 31.39%. Specific studies reported high rates, including 52% among Rajasthan mine workers and 69.1% among Khambhat agate workers. Additionally, screening tools, like CC16 protein levels, showed promise for early diagnosis, while qualitative studies highlighted gaps in awareness and regulatory practices. Meta-analysis revealed a significant pooled prevalence (25.98%) and marked variability (I2 = 98.86%), underscoring the need for targeted interventions and worker protections. Conclusions: This review of current knowledge on silicosis in India finds silicosis highly prevalent among workers in mining and stone industries, with gaps in regulatory enforcement and awareness. Biomarkers like CC16 offer the potential for early diagnosis, underscoring the need for preventive measures. Policy recommendations include stricter dust exposure limits, enhanced workers' education, routine screening, and improved access to protective equipment and health monitoring to reduce the risk of silicosis and health disparities in vulnerable occupational groups. [ABSTRACT FROM AUTHOR]