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Diabetic mellitus, a metabolic disorder, has a high incidence and morbidity. Of all complications, diabetic foot ulcer is one of the commonest with 25% likelihood of a diabetic to develop diabetic for ulcers. Infection in a diabetic foot ulcer is a dreaded complication with often complicates the clinical course of the patient and is managed by local and systemic antibiotics. Local antibiotics are generally deemed ineffective in various studies due to lack of an appropriate drug delivery system. The Vit D level is inversely related to development of diabetic vascular disease. A novel strategy for treating diabetic foot ulcer with osteomyelitis may be using topical antibiotics with drug delivery system which will have minimum systemic side effects. Our case, a middle age male, having right foot diabetic ulcer with (Wagner stage 2) uncontrolled sugar levels. A trial of topical antibiotic therapy with tobramycin using cholecalciferol granules as a drug delivery system was given. Regular dressing was continued and serial wound cultures were taken. The wound culture was became sterile after 4 application of the therapy (14 days) with cholecalciferol granules with healthy granulation. The wound was fit for reconstruction after 5 applications. This report is an attempt to bring to the notice that such a drug delivery system is efficacious and may be validated using a larger trial. Keywords: Topical cholecalciferol, Antimicrobial drug delivery, Diabetic foot ulcer.

Background: Unsafe abortion continues to draw the researcher's attention due to its close association with maternal morbidity and mortality. Empirical evidence on the role of health facilities in providing safe abortion care addressing the reproductive rights of Indian women is limited.Methods: Using data from the 2015 ‘unintended pregnancy and abortion in India’ study, the present paper aimed to understand the violation of the reproductive rights of abortion care seekers in health facilities (n=4001) in six states of India. The health facilities were sampled using a stratified random sampling strategy. Univariate and bivariate analysis was carried out using SPSS (V 25) on cleaned and weighted data.Results: A sizeable percentage of public and private health facilities across states found seeking the consent of the husband or family members before abortion provision, compel women to adopt contraception and turn away abortion seekers, commonly citing non-medical reasons. The provision of post-abortion complications services is usually not 24/7, even at the primary health centre level, hindering access to an urgent health care need.Conclusions: There is a need to improve access to facility-based abortion services, especially in underserved rural areas, by ensuring that all public-sector facilities have adequate equipment and supplies, including MMA drugs and trained providers. Sensitization of health care providers about the importance of ethical issues and women’s reproductive rights is urgently required to ensure safe, legal, and accessible abortion care.

The objective of this study was to determine if the adaptation at planktonic stage to subinhibitory concentrations (SIC) of sodium hypochlorite (NaOCl) could modulate the biofilm forming ability of five Listeria monocytogenes strains V7, Scott A, FSL-N1-227, FSL F6-154 and ATCC 19116 representing serotypes 1/2a, 4b and 4c. Biofilm formation by NaOCl nonadapted and adapted L. monocytogenes planktonic cells was measured in the presence or absence of SIC of NaOCl. The biofilm formation ability of NaOCl nonadapted and adapted L. monocyotgenes planktonic cells was reduced only in the presence of NaOCl (P 0.05). Scanning electron microscopy revealed that the continuous exposure of NaOCl induced morphological changes in the L. monocytogenes biofilm structure and reduced its attachment to polystyrene surface. The qRT-PCR results also showed that the subinhibitory NaOCl reduced biofilm formation related gene expression such as motility and quorum sensing signals (P 0.05). These findings indicate that subinhibitory NaOCl can reduce the ability of L. monocytogenes planktonic cells to form biofilms on polystyrene surface.

Endoscopic ultrasound-guided drainage is a minimally invasive first-line modality for the drainage of pancreatic fluid collection (PFC) resulting in a shorter hospital stay and less morbidity compared with surgical cystogastrostomy. Our aim is to evaluate potential differences in the outcomes of endoscopic ultrasound (EUS) guided transmural drainage (EUS-TD) drainage of pancreatic pseudocyst (PP) and walled-off necrosis (WON).We retrospectively reviewed 100 consecutive EUS-guided drainages of PFC utilising EUS reports; clinical notes and imaging with follow-up (FU) to 12 months. All procedures were undertaken under conscious sedation with EUS guidance alone (without fluoroscopy) and placement of plastic double pigtail stents.In these 100 sequential cases, there were 78 cases of PP and 22 cases of WON. All 22/22(100%) cases of WON had successful EUS-guided stent placement. In 2/22(9%), there was little or no clinical improvement. These two patients required further computed tomography (CT)-guided drainage and one of these patients (1/22) (4.5%) developed recurrence within 12 months FU after removal of stents. In case of PP, overall stent placement was successful in 76/78 (97%) patients, but 6/78(8%) required 2nd EUS procedure after failure to show clinical improvement; 3/78(2.5%) required further CT-guided drainage. The overall complication rate was 9%(9/100) with 4%(4/100) requiring endoscopic or CT-guided intervention with no overall 30-day mortality.This is the largest series from a single UK centre demonstrating that EUS-guided cystogastrostomy of PFC drainage using plastic double pigtail stents is sufficient in majority of cases with PFC including that of WON, with or without infection.

The nationwide listeriosis outbreak that occurred in the United States during 2011 highlighted the importance of preventing cantaloupe contamination with Listeria monocytogenes ( Lm ) within farm and processing environments. The objectives of this study were to determine the effects of strain and temperature on growth and biofilm formation of Lm in cantaloupe flesh and peel extracts on different food-contact surfaces. Growth of Lm strains was markedly greater at high concentration of cantaloupe extracts and temperature in comparison to low concentration and temperature. For 50 mg/ml of cantaloupe extract inoculated with 3 log CFU/ml, the growth of Lm was 8.5 log CFU/ml in 32 h at 22 °C and 6–7 log CFU/ml in 72 h at 10 °C. For 2 mg/ml of cantaloupe extract that was inoculated with Lm, the growth was 7–7.5 log CFU/ml in 72 h at 22 °C and 3.5 log CFU/ml in 72 h at 10 °C. There were no differences ( P > 0.05) among Lm strains for biofilm formation in cantaloupe extracts, but biofilm formation was greater at high temperature and high concentration. For 50 mg/ml cantaloupe extracts inoculated with 3 log CFU/ml, the biofilm formation of Lm on stainless steel surface was approximately 7 log CFU/coupon at 22 °C in 4–7 days and 5–6 log CFU/coupon at 10 °C in 7 days. For 2 mg/ml cantaloupe extracts, the biofilm formation of Lm on the stainless-steel surface was approximately 5–6 log CFU/coupon at 22 °C and 4–4.5 log CFU/coupon at 10 °C in 7 days. The biofilm formation by cantaloupe outbreak strain Lm 2011L-2625 in cantaloupe extracts was least on buna-n rubber when compared to stainless steel, polyethylene and polyurethane surfaces ( P Lm growth and subsequent biofilm formation on different food-contact processing surfaces.

Mountain Glaciers are natural resources of fresh water and these affect the stream flow of the rivers, regional climate and further global climate. Observed trends and projected future evolutions of climate and Cryospheric variables clearly suggest a need to monitor these changes. Accordingly, the article presents the glacier features mapping using Hyperspectral remote sensing imagery. A freely available Hyperion satellite imagery acquired over Gepang Gath glacier in Himachal Pradesh, India is used for the study. Each class is identified based on their surface characteristics of spectral reflectance properties. Identification is simplified by demarcating the study glacier into accumulation and ablation areas through snowline. Accumulation area is characterized with high reflectance clean snow/ice and reduced moderate reflectance Snow/firn. The identification of classes in Hyperion imagery is validated using the spectral library from USGS and ASTER, and field spectra obtained from literature.

The main objective of this study was to examine the efficacy of USDA approved antimicrobials in reducing Salmonella Heidelberg (S. H.) and Campylobacter jejuni (C. j.) in ground chicken frames and to determine the treatment effects on total aerobic counts and meat color. Six antimicrobials (0.1% peracetic acid [PAA], 0.6% cetylpyridinium chloride [CPC], 0.005% sodium hypochlorite, 1.5% acidified lactic acid [ALA], 0.3% propionic acid, and 0.1% lauric arginate [LAE]) applied as dip treatments were evaluated in their efficacy in reducing S. Heidelberg and C. jejuni. Fresh chicken frames were spot inoculated with nalidixic acid resistant S. H. and C. j. (ATCC 33291) to achieve a recovery level of ca. 3 log CFU/g in the ground product. Frames were dipped for 10 s in each antimicrobial solution and each treatment was replicated on 3 frames. Three separate replications were conducted for this experiment. Frames were blended, and ground samples similar to mechanically separated chicken (MSC) were obtained and stored at 4°C for 24 hours. Samples were analyzed after grinding on d zero (2 h) and d one (24 h) to determine reduction in S. H. and C. j. counts in MSC. PAA and LAE treatments had the highest reductions on Salmonella counts (P ≤ 0.05), both treatments resulting in 0.9 log CFU/g reduction as compared to control on d zero. PAA and CPC reduced Salmonella counts by 1.4 and 0.9 log CFU/g, respectively, on d one; PAA, propionic acid, ALA, and LAE resulted in one log CFU/g reductions of C. j. as compared to control on d one. There was no significant difference among the treatments in their ability to reduce C. j. on d one. The treatments had no effect on total aerobic counts. The findings from the study indicate that PAA, CPC, and LAE can reduce S. H. in ground chicken frames, whereas all the antimicrobials tested in the study, except chlorine, have the ability to reduce C. j. in ground chicken frames, a product similar to commercial MSC.

This paper presents studies carried out on amorphous silicon solar panels for electrical power generation in the city of Hassi Messaoud, Ouargla. The electrical power generation has been studied as a function of the amount of irradiation received and the angle of optimum orientation of the solar panels. An optimal angle of 32 degrees is chosen and the amount of solar radiation received is studied. A direct correspondence was observed between the incident solar radiation and the power generated. The maximum variable power is generated between the months of March and October. During the winters, the power generated slows down as the solar radiation available decreases. The power generated by amorphous silicon solar is almost ∼ 20% less than the same generated by the crystalline Silicon solar panels under similar conditions.

Study Objective Polycystic ovary syndrome (PCOS), the most common endocrinopathy of women, is a state of chronic low-grade inflammation and is closely linked to type 2 diabetes mellitus and cardiovascular disease. Oral contraceptive pills (OCPs), is the usual first choice of treatment in women with PCOS. Because OCP use has been linked to the risk of venous thrombosis and there are limited data on the effect of OCP use on the inflammatory state of women with PCOS, our objective was to compare the levels of intercellular adhesion molecule (ICAM)-1, tumor necrosis factor (TNF)-α, and monocyte chemoattractant protein (MCP)-1 between drug-naive and OCP-treated women with PCOS. Design, Setting, Participants, Interventions, and Main Outcome Measures Consequent to women diagnosed with PCOS on the basis of Rotterdam 2003 criteria, either treated with OCPs (ethinylestradiol 0.03 mg, levonogestrel-0.15 mg) for a period of 6 months (n = 50) or drug-naive (n = 51) were enrolled in this cross-sectional study. Results The mean ages of patients and control participants were comparable (21.99 ± 4.78 vs 21.92 ± 5.83 years; P = .947) as was body mass index (24.47 ± 3.92 vs 23.66 ± 3.43; P = .271). Clinical and androgen excess symptoms were significantly better in the OCP group compared with the drug-naive group (P = .01, P = .04). Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the OCP group (P = .01). Plasma ICAM-1 levels, TNF-α levels, and MCP-1 levels showed a higher trend in patients but reached statistical significance only in cases of ICAM-1 and TNF-α (P = .01). Conclusion OCP treatment of 6 months increases plasma ICAM-1, MCP-1, and TNF-α levels among women with PCOS, although OCPs significantly help in ameliorating features of hyperandrogenism and regularizing menstrual cycles. These cytokines correlate positively with many metabolic parameters including plasma glucose, lipids, and homeostatic model assessment-insulin resistance. Further investigation with well designed, randomized, longitudinal studies might help to ascertain the effect of OCPs on proinflammatory profiles among women with PCOS.

The present study has been undertaken to fit best probability distribution of rainfall in Ambala District of Haryana State. The analysis showed that the maximum daily rainfall among the years ranged between 41mm (1980) to 307.9mm (2009) indicating a very large variation during the period of study. The mean of maximum daily rainfall of all years annually is 112.13mm. The means of monthly and weekly values ranged from 33.10-88.92mm and 8.77- 46.28 mm, respectively. The maximum daily rainfall in a year/monsoon season was307.9 mm and monthly maximum daily rainfall in monsoon season ranged from 105 -307.9mm. The weekly maximum daily rainfall ranged from48 mm-307.9 mm. It was also observed that the minimum among the maximum daily rainfall was 41mm for annual, 34mm for season and 0 in all the months and weeks. The maximum value of coefficient of variation was observed in the first week which indicated a large fluctuation in the rainfall data set and minimum value of coefficient of variation 0.464 was observed for the whole year which shows that fluctuation was minimum for the whole year. Generalized extreme value distribution was found to be best fit probability distribution for most of the periods.

Food processing and food handling environments may contain residual levels of sanitizers or cleaners which may trigger oxidative stress adaptation in Listeria monocytogenes. The aim of this study was to determine the induction and stability of oxidative stress adaptation in L. monocytogenes EGD (Bug600) (serotype 1/2a) and F1057 (serotype 4b) at different concentrations and times of sublethal oxidative stress induced by H2O2 or sublethal alkali stress induced by NaOH at 37°C. Both L. monocytogenes Bug600 and F1057 strains showed significantly higher survival in lethal oxidative stress (1000ppm H2O2) after pre-exposure to 50ppm H2O2 for 30min compared to control cells (no pre-exposure to H2O2). When the cells were pre-exposed to sublethal alkali stress by NaOH, the oxidative stress adaptation was induced within 5min in L. monocytogenes. The survival of both L. monocytogenes strains was increased by 2 to 4.5 logs in lethal oxidative stress when the cells were pre-exposed to sublethal alkali stress at pH9 from 5 to 120min by NaOH compared to control cells (no pre-exposure to sublethal alkali pH). Two other alkali reagents tested (KOH and NH4OH) also induced oxidative stress adaptation in L. monocytogenes. For both L. monocytogenes strains, the oxidative stress adaptation induced by sublethal H2O2 was reversible in 30min and that induced by sublethal alkali stress was reversible within 60min at 37°C in the absence of such sublethal stress. These findings show that sublethal oxidative or alkali stress conditions can induce oxidative stress adaptation that may increase the risk of survival of L. monocytogenes cells in lethal oxidative stress.

The effect of hydrogen passivation and heat treatments on the electronic activity at grain boundaries in thin films of polysilicon deposited by LP-CVD (Low Pressure Chemical Vapor Deposition) has been studied. The results obtained have shown that the introduction of hydrogen into polysilicon thin films doped with arsenic ions increases the concentration of free carriers, reduces the resistivity and lowers the density of trap states at the grain boundaries. Free carriers concentration improved by almost 10% at the annealing temperature of 1000 °C. In addition, it was found that the effect of hydrogen is much more pronounced for low temperature heat treatment before doping compared to the effect at the higher temperature. Moreover, the increase in free carrier concentration and the decrease in resistivity of polysilicon thin films with the increase in the annealing temperature has been observed.

Salmonella biofilms act as a continuous source for cross-contamination in the food processing environments. In this study, a stable rugose morphotype of Salmonella was first induced by sequential exposure to subinhibitory concentrations (SICs) of sodium hypochlorite (NaOCl) (ranging from 50 to 300 ppm over 18-day period) in tryptic soy broth. Then, rugose and smooth morphotypes of Salmonella Typhimurium ATCC 14028 and Salmonella Heidelberg ATCC 8326 were characterized for biofilm forming abilities on polystyrene and stainless steel surfaces. Rugose morphotype of both ATCC 14028 and ATCC 8326 exhibited higher Exopolysaccharide (EPS) formation than smooth morphotype (p ≤ 0.05). Also, the SICs of NaOCl (200 or 300 ppm in broth model) increased the biofilm formation ability of rugose morphotype of ATCC 8326 (p ≤ 0.05) but decreased that of ATCC 14028. The 2-day-old Salmonella biofilms were treated with biocidal concentrations of 50, 100, or 200 ppm NaOCl (pH 6.15) in water for 5, 10, or 20 min at room temperature. The biofilm reduction in CFU/cm2 for the rugose was lower than the smooth morphotype on both surfaces (p ≤ 0.05) by lethal NaOCl in water. Scanning electron micrographs on both polystyrene and stainless steel surfaces demonstrated that the rugose morphotype produced a denser biofilm than the smooth morphotype. Transmission electron micrographs revealed the cell wall roughness in rugose morphotype, which may help in tolerance to NaOCl. The gene expression data indicate that the expression of biofilm regulator (csgD), curli (csgA, csgB, and csgC), and cellulose (bcsE) was significantly increased in rugose morphotype when induced by sequential exposure of NaOCl SICs. These findings reveal that the rugose morphotype of S. Typhimurium and S. Heidelberg produced significantly denser biofilm on food contact surfaces, which also increased with sequential exposure to SICs of NaOCl in the case of S. Heidelberg, and these biofilms were more tolerant to biocidal NaOCl concentrations commonly used in the food processing plants.

The study aims to examine the linkages between occupation and elevated blood pressure among men aged 25–54 years in India. The study is based on the National Family Health Survey India, 2015–16. Age-standardized prevalence rates, χ2 tests and multivariable ordered logistic regression models were used to fulfill the study objectives. In India, more than five out of hundred men of age group 25–54 years are suffering from moderately or severely elevated blood pressure levels. The findings depict an occupation wise inequality in the elevated blood pressure levels. Men belonging to professional-managerial-technical (PR = 6.42 per 100 men) and sales (PR = 6.10 per 100 men) occupational groups are facing a much higher burden. From the fitted multivariable ordered logistic models, we found that highly educated-unemployed and married-unemployed men were found to be at higher risk of elevated blood pressure levels. The study found linkages between the occupation of men and elevated blood pressure levels in India. Urgent attention is needed to the vulnerable occupational groups like professional-technical-managerial, clerical, and sales with a special focus to the unemployed cohort of the country.

Background: Millennium Development Goal 4 (MDGs) mobilised countries to reduce child mortality by two thirds the 1990 rate in 2015. While India did not reach MDG 4, it considerably reduced child mortality in the MDG-era. Efficient and targeted interventions and adequate monitoring are necessary to further progress in improvements to child health. Looking forward to the Sustainable Development Goal (SDG)-era, the Indian Council of Medical Research and The INCLEN Trust International conducted a national research priority setting exercise for maternal, child, newborn health, and maternal and child nutrition. Here, results are reported for child health.Methods: The Child Health and Nutrition Research Initiative (CHNRI) method for research priority setting was employed. Research ideas were crowd-sourced from a network of child health experts from across India; these were refined and consolidated into research options (ROs) which were scored against five weighted criteria to arrive weighted Research Priority Scores (wRPS). National and regional priority lists were prepared.Results: 90 experts contributed 596 ideas that were consolidated into 101 research options (ROs). These were scored by 233 experts nationwide. National wRPS for ROs ranged between 0.92 and 0.51. The majority of the top research priorities related to development of cost-effective interventions and their implementation, and impact evaluations, improving data quality; and monitoring of existing programs, or improving the management of morbidities. The research priorities varied between regions, the Economic Action Group and North-Eastern states prioritised questions relating to delivering interventions at community- or household-level, whereas the North-Eastern states and Union Territories prioritised research questions involving managing and measuring malaria, and the Southern and Western states prioritised research questions involving pharmacovigilance of vaccines, impact of newly introduced vaccines, and delivery of vaccines to hard-to-reach populations.Conclusions: Research priorities varied geographically, according the stage of development of the area and mostly pertained to implementation sciences, which was expected given diversity in epidemiological profiles. Priority setting should help guide investment decisions by national and international agencies, therefore encouraging researchers to focus on priority areas. The ICMR has launched a grants programme for implementation research on maternal and child health to pursue research priorities identified by this exercise.

Nationally representative evidence on abortion service provision is scarce in South Asia. To inform improvements in service provision, this paper assesses the availability of facility-based postabortion services in Nepal, India (six states), Bangladesh and Pakistan, and legal abortion services in India and Nepal and Bangladesh (where the official term used is menstrual regulation or MR).The paper presents comparable indicators on three aspects of abortion service provision from representative surveys of public and private sector facilities, conducted over 2012-2015. Indicators cover three areas: (a) need for abortion-related care (total number of abortions and percent of abortions that are legal and the postabortion treatment rate); (b) availability and accessibility of facility-based abortion-related services (percent of facilities offering only one of the two services, percent which are public and percent located in rural areas); (c) quality of facility-based abortion care (percent of legal abortions using procedures not recommended by WHO and percent of women turned away when seeking abortion or MR services).The proportion of all abortions that are illegal ranges from 58% to almost 78% in the three countries where abortion is permitted under broad criteria. The annual treatment rate for abortion complications ranges from about 4 to 26 per 1000 women ages 15-49 across the countries and states covered. In India and Nepal, less than 40% of public sector facilities that are permitted to provide abortion services do so; in Bangladesh, the situation is somewhat better, at 53% providing MR. Across the six Indian states, 4-43% of facilities that offer abortion care are located in rural areas, disproportionately lower than the proportion of women living in rural areas (49-87%). About 30-60% of facilities offered only postabortion care and did not offer legal services in the three countries where legal services are permitted (with the sole exception of Tamil Nadu where this proportion was only 11%); of the remaining facilities, the large majority offered both services. Medication abortion is offered by the large majority of facilities that provide induced abortion and accounts for 40-45%, of facility-based abortions in Nepal and four of the states of India; in Assam and Bihar, this proportion was much lower (13% and 27% respectively). Invasive procedures that are not recommended by WHO are more widely used in India (up to 25-37% of facility-based abortions are DC procedures; the large majority of this group are DC, and a small proportion may be DE, a WHO-recommended abortion procedure, that could not be separated out in this study because providers use the two labels interchangeably); by comparison, the proportion is much smaller in Nepal (5%). Between 22% to a little over half of facilities turned away some women who would otherwise be eligible for an abortion or MR procedure in Nepal, the six Indian states, and Bangladesh.There is an urgent need to increase access to abortion, MR and postabortion services, especially for rural women. Greater access to legal abortion/MR services in the three countries that permit these procedures would increase the proportion of abortions that are legal and safe, reduce morbidity and the need for facility-based treatment for complications. Broadening the legal criteria under which abortion is permitted in Pakistan, and implementing access under such broader criteria, is needed to achieve the same improvements in Pakistan. Ensuring that these services are of high quality and comprehensive-meeting WHO-recommended standards-is essential to protect women's reproductive health and rights.To improve access to abortion, MR and postabortion care in South Asia, all facilities (public and private) permitted to provide these services should do so, and should include medication abortion. Improvements in quality of care are critical: invasive procedures (DC) should be eliminated through adherence to WHO's standards of safe abortion care and women seeking abortions should not be turned away because of providers' biases.

Medical methods of abortion, MMA, has been legal in India since 2002. Guidelines stipulate that it should be administered by a provider or acquired via prescription. 1.2 million women having abortions in India use MMA acquired from health facilities [Singh, S., Shekhar, C., Acharya, R., Moore, A. M., Stillman, M., Pradhan, M. R., … Browne, A. (2018). The incidence of abortion and unintended pregnancy in India, 2015. The Lancet Global Health, 6(1), e111-e120. doi: 10.1016/S2214-109X(17)30453-9 ]. We undertook a study of abortion in Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh in 2015 to better understand under what conditions and how MMA is being administered in facilities. The majority of facilities that provide MMA are in the private sector and located in urban areas. Most facilities offer MMA both at the facility and as a prescription, although some facilities only offer MMA as a prescription. A high proportion of facilities report that women typically take the medication at home. (Re)training providers in MMA protocols and counselling, increasing the number of facilities offering MMA, and stocking of the drugs would help improve women's access to MMA and the information they need to be able to use this method safely. Key Messages: In the six states in our sample, Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh, 8% of abortions in 2015 were done using medical methods of abortion (MMA) acquired from health facilities. The majority of facilities that provide MMA in the six states are in the private sector and are located in urban areas. Health facilities in Madhya Pradesh and Tamil Nadu are comparatively better in their provision of MMA with Assam, Bihar, Gujarat and Uttar Pradesh demonstrating poorer provision of MMA. There are many opportunities for improvement in the practices of MMA provision through improved training of providers, accessibility to the medications and better support of women using MMA.

Objective Although abortion has been legal in India since 1971, but very little research has been done so far on the issue of the quality of abortion services. To fill this gap, this paper examines whether the quality of abortion services provided in the country is in line with the WHO’s recommendations. Study Design: We analyse a cross-sectional health facilities survey conducted in six Indian states, representing different sociocultural and geographical regions, as part of a study done in 2015. Main outcome measures: Percentage of facilities offering different abortion methods, type of anaesthesia given, audio-visual privacy level, compliance with the law by obtaining woman’s consent only, imposing the requirement of adopting a contraceptive method as a precondition to receive abortion. Results Except for the state of Madhya Pradesh, fewer than half of the facilities in the other states offer safe abortion services. Fewer than half of the facilities offer the WHO recommended manual vacuum aspiration method. Only 6–26% facilities across the states seek the woman’s consent alone for providing abortion. About 8–26% facilities across the states also require that women adopt some method of contraception before receiving abortion. Conclusion To provide comprehensive quality abortion care, India needs to expand the provider base by including doctors from the Ayurveda, Unani, Siddha, and Homeopathy streams as also nurses and auxiliary midwives after providing them necessary skills. Medical and nursing colleges and training institutions should expand their curriculum by offering an in-service short-term training on vacuum aspiration (VA) and medical methods of abortion.

Bone and soft tissue infections are difficult problems in orthopedic surgery. Infections resulting in chronic osteomyelitis if established are difficult to eradicate. The delivery of local antibiotics for the treatment of open infected wounds of the musculo skeletal system is a more logical approach to treat these infections. Antibiotics given systemically are unable to achieve minimum inhibitory concentration in areas of infected wounds which are ischemic or relatively avascular. And also these antibiotics given over a prolonged period lead to significant toxicity and side effects and emergence of resistant bacteria. The author has been treating difficult cases of infected wounds sustained in road accidents, wounds (diabetic ulcers) in Diabetes Mellitus with necrotizing fasciitis and post operative infections with discharging sinuses with infected implants inside by his own innovative method of antibiotic delivery. The infected open wounds have been treated by application of Vitamin D3 granules impregnated with Tobramycin or Tobramycin and Vancomycin combined. All the patients responded successfully to this novel method of treatment which is extremely simple, effective, low cost, without any complications or side effects and has shown excellent results. Not only the Vitamin D3 granules act as a carrier of the antibiotic locally but also have properties of boosting immunity, and promote tissue healing. It also produces an antibiotic like substance Cathelicidin which kills bacteria and promotes growth of the bone and restores the bone mineral density.

ACS Applied Materials & Interfaces, 11 (30), ISSN:1944-8244, ISSN:1944-8252

Tungsten carbides (WC) coatings have been deposited by RF magnetron sputtering onto steel substrate (XC70) temperature in the range of 500-1000 °C under vacuum for 25 minutes. The mechanical properties of WC were investigated by the measurements of microhardness by Vickers tests. We carried out microhardness tests with loads varying between 10 g and 1000 g, and the variations of the microhardness of our samples were followed as a function of the annealing temperature, the applied load and the penetration depth of the indenter.

The present study was conducted to evaluate the effect of chlorine-induced oxidative stress on biofilm formation by various Salmonella strains on polystyrene and stainless steel (SS) surfaces at three temperatures (30, 25 [room temperature], and 4°C) in tryptic soy broth (TSB) and 1/10 TSB. Fifteen Salmonella strains (six serotypes) were exposed to a sublethal chlorine concentration (150 ppm of total chlorine) in TSB for 2 h at the predetermined temperatures. The biofilm-forming ability of the Salmonella strains was determined in 96-well polystyrene microtiter plates by using a crystal violet staining method and on SS coupons in 24-well tissue culture plates. All tested strains of Salmonella produced biofilms on both surfaces tested at room temperature and at 30°C. Of the 15 strains tested, none (chlorine stressed and nonstressed) formed biofilm at 4°C. At 30°C, Salmonella Heidelberg (ID 72), Salmonella Newport (ID 107), and Salmonella Typhimurium (ATCC 14028) formed more biofilm than did their respective nonstressed controls on polystyrene ( P ≤ 0.05). At room temperature, only stressed Salmonella Reading (ID 115) in 1/10 TSB had significantly more biofilm formation than did the nonstressed control cells ( P ≤ 0.05). Salmonella strains formed more biofilm in nutrient-deficient medium (1/10 TSB) than in full-strength TSB. At 25°C, chlorine-stressed Salmonella Heidelberg (ATCC 8326) and Salmonella Enteritidis (ATCC 4931) formed stronger biofilms on SS coupons ( P ≤ 0.05) than did the nonstressed cells. These findings suggest that certain strains of Salmonella can produce significantly stronger biofilms on plastic and SS upon exposure to sublethal chlorine.

Introduction Pregnancy loss is a public health issue throughout the world. Miscarriage and induced abortion are the two main dimensions of pregnancy loss. The prevalence of early pregnancy loss due to miscarriage and abortion is mostly unknown due to the lack of early registration of pregnancies in most places, and especially in low- and middle-income countries. In a country like India, not enough attempts have been made to recognize pregnancy loss by weeks of gestational age. Objective This study aims to know about the age-pattern of gestational termination using the calendar information from the fourth round of the National Family Health Survey. Statistical Methods A generalized linear model with a binomial distribution assumption and Kaplan-Meier survival model with left truncation was used for statistical analysis. Results The age-pattern of miscarriage produces a vertical convex shape curve when age is drawn at y-axis and the miscarriage rate at x-axis. There is a high relative risk of miscarriage to women age below 20 years and age 35 years onwards, whereas abortion risk was high among women age 30 and above years. Among women age 15–19 years, the abortion rate at 27 abortions per thousand pregnancies was the highest in the northeast region, and the miscarriage rate at 67 miscarriages per thousand pregnancies was estimated to be the highest in the western region among all the regions. A sizeable proportion of miscarriages and induced abortions also occurred in the second trimester and all the region. Conclusion This article brings out that miscarriage is more commonly prevalent among women in the adolescence age 15–19 years and in the latter half of the reproductive span, whereas the incidence of abortion increases with age. The western and the northeast regions registered maximum miscarriage and abortion rates among women age 15–19, respectively. The central region as a whole showed the highest rate of miscarriage, whereas the abortion rate was the highest in the northeast region in India. The findings of the study will be beneficial in making appropriate policy provisions for postponing pregnancies among women in their adolescence and preventing the occurrence of miscarriages among more vulnerable age groups of women and regions by providing a complete package of high-quality antenatal care services.

We examine the information role of financial advisors by focusing on mergers and acquisitions in which acquiring firms hire target firms’ ex-advisors. We document that by employing targets’ ex-advisors, acquirers pay lower takeover premiums and secure a larger proportion of merger synergies. The corresponding targets exhibit lower announcement returns and are less likely to be propositioned by competing bidders. These results indicate that acquirers take advantage of value-relevant information about targets through targets’ ex-advisors, and achieve bargaining advantages in deal negotiations. In contrast, we document no discernible value effects when targets hire acquirers’ ex-advisors, suggesting that the information role of acquirers’ ex-advisors hired by targets is weaker than that of targets’ ex-advisors hired by acquirers. Accepted version

A systematic study on the effect of heat treatment on the structural properties of tungsten carbides coatings deposited by RF magnetron sputtering on steel substrate (XC70) was carried out. These coatings were subjected to heat treatment in vacuum at various temperatures ranging from 500 to 1000 °C for 25 min. Structural analysis of the as-deposited and heat-treated coatings was performed by means of X-ray diffraction (XRD) and optical microscopy. The XRD analyses indicated the presence of nanocrystalline grains with (222) preferential orientation. The grain size varied from 8 to 15 nm. The presence of two different phases WC and W2C was observed in the coatings heat treated at 1000 °C. The effect of the annealing temperature on the surface morphology of the coatings was studied using optical microscopy.

Listeria monocytogenes cells may induce alkali stress adaptation when exposed to sublethal concentrations of alkaline cleaners and sanitizers that may be frequently used in the food processing environment. In the present study, the effect of temperature on the induction and the stability of such alkali stress adaptation in L. monocytogenes were investigated. Our results demonstrate that temperature plays a critical role in the induction of alkali stress adaptation in L. monocytogenes under sublethal alkaline conditions. Pre-exposure to pH 9.0 tryptic soy broth supplemented with 0.6% yeast extract (TSB-YE) at 37 °C induced pronounced alkali stress adaptation whereas sublethal alkaline pre-exposure at 4 °C failed to induce any alkali stress adaptation. Furthermore, this pattern of alkali stress adaptation in L. monocytogenes was not dependent on the length of pre-exposure time, the concentration of sublethal alkali, the types of alkaline agents and the growth phases of cells. In addition, alkali stress adaptation induced at 37 °C was completely reversed in pH 7.2 TSB-YE within 2 h at 37 °C or within 4 h at 22 °C. However, once it was induced at a higher temperature, alkali stress adaptation in L. monocytogenes remained stable at 4 °C for at least 4 h. Our findings suggest that even though cold temperatures do not induce alkali stress adapted phenotypes, but it can maintain the previously acquired alkali stress adaptation much longer in L. monocytogenes.

This paper examines the impacts of M&A advisors’ industry expertise on firms’ choice of advisors in mergers and acquisitions. We show that an investment bank's expertise in merger parties’ industries increases its likelihood of being chosen as an advisor, especially when the acquisition is more complex, and when a firm in M&A has less information about the merger counterparty. However, due to the concerns about information leakage to industry rivals through M&A advisors, acquirers are reluctant to share advisors with rival firms in the same industry, and they are more likely to switch to new advisors if their former advisors have advisory relationship with their industry rivals. In addition, we document that advisors with more industry expertise earn higher advisory fees and increase the likelihood of deal completion.

Hotspots in microprocessors arise due to non-uniform utilization of the underlying integrated circuits during chip operation. Conventional liquid cooling using microchannels leads to undercooling of the hotspot areas and overcooling of the background area of the chip resulting in excessive temperature gradients across the chip which adversely affects the chip performance and reliability. This problem becomes even more acute in multi-core processors where most of the processing power is concentrated in specific regions of the chip called as cores. We present a one-dimensional, semi-empirical approach for quick design of a microchannel heat sink for targeted, energy efficient liquid cooling of hotspots in microprocessors. Our approach enables targeted manipulation of the local cooling capacity in the microchannel heat sink, which in turn minimizes the chip temperature gradient. The method is formulated to design a heat sink for an arbitrary chip power map and hence can be readily utilized for different chip architectures. It involves optimization of microchannel widths and flow rate distribution for various zones of the power map under the operational constraints of maximum pressure drop limit for the heat sink. Additionally, it ensures that the coolant flows uninterrupted through its entire travel length consisting of microchannels of varying widths. The resulting design estimate significantly reduces the effort involved in designing hotspot-targeted heat sinks.

Background: Postpartum amenorrhea is considered to be the conception variable and its affect natural fertility by lengthening the inter-live birth interval. In societies where the fertility is not regulated through the use of contraception method there amenorrhea period can exert a dominant fertility inhibiting effect on fertility. In this paper we check differentials in duration of breastfeeding and Postpartum Amenorrhea (PPA), and to estimate mean duration of Postpartum Amenorrhea (PPA) associated with breastfeeding with influence of Scio-economic and demographic factors of ever-married woman who had given at least one but last birth in Bihar, India. Methods: Kaplan Meier Survival method use to estimate the duration of breastfeeding and postpartum amenorrhea and multivariate Cox proportional hazard model used to measure the effect of each category of each variable on the hazard function while controlling for the effects of other variables (and their categories) included in the model. Results: Duration of breastfeeding, parity, residence, contraceptive use have a significant impact on duration of postpartum amenorrhea (PPA) and empirical evidence indicates that longer and more frequent breastfeeding may increase the length of an ovulatory period. Mothers with a BMI greater than 18.5 kg/m 2 resume ovulation faster and high mean for duration of breastfeeding than those with a lower BMI. Conclusions: Parity, age of mothers, survival status of child and socio-economic status of mothers are found to be the main influencing factors for the timing of postpartum amenorrhea and also duration of breastfeeding among mothers., it is expected that the findings may help in designing appropriate policies and programs for improving mothers' and children's health as well as for reducing the existing fertility level of a region where contraceptive practices is low.

Background: There are a high proportion of home deliveries in rural India. The present study was carried out to assess newborn care practices among home births and reasons for delivering at home. Methods: A community based cross sectional survey of recently delivered mothers (