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Abstract Fluorescent Carbon Quantum Dots (CQDs) are being used in medical applications, particularly in theranostics. These Carbon Quantum Dots have been gaining more attention lately due to their potential as an effective replacement for hazardous synthetic organic dyes in a variety of biomedical applications, including live cell imaging and diagnostics. In this study, highly fluorescent Carbon Quantum Dots by one pot microwave based green route with a size of less than 10 nm, was prepared from commercially available almond resin, Prunus dulcis and conjugated with honey as additional reagent for surface functionalization. They exhibit a deep blue emission on excitation at 350 nm with an elevated quantum yield at 61%. They possess atomic nature and basic features such as high photo-stability, varying fluorescence, greater biocompatibility, and better water solubility. These fluorescent labels exhibit faster cellular invagination without disturbing the cell stability. The CQDs present cell imaging capacity with multi-coloration for visualizing the fine architecture of the nucleus naming, the nuclear membrane and nucleolus, which is linked with their varied, surface structures such as amphiphilic property and higher positive charges. These characteristics with minimal invasion have made carbon quantum dots to become the spotlight in theranostics. They can be used as alternatives to synthetic dyes for fluorescence- related cell-imaging. The intriguing fact about this approach is that it opens the possibility of combining therapy and diagnostics into one unit, which can alter how some diseases are handled and, in turn, transform the field of healthcare.

The experiment was conducted during 2019 and 2020 at Regional Research Station (Punjab Agricultural University, Ludhiana, Punjab), Faridkot, Punjab to evaluate the impact of different drip irrigation and fertigation regimes on Bt cotton (Gossypium hirsutum L.) (cv. RCH 773 BGII). The experiment was conducted in a randomized complete block design (RCBD) comprised of 3 drip irrigation levels (60%, 80%, and 100% of ETc); 2 fertigation doses (75% and 100% of recommended nitrogen dose), along with two extra control treatments (surface flood irrigation with 105 kg N/ha and subsurface flood irrigation with 112.5 kg N/ha). Results revealed that surface drip irrigation significantly reduced water usage by 13.9–32.3% as compared to conventional surface flood irrigation, while seed cotton yield increased by 18.2–25.2%. Notably, subsurface drip fertigation (SSDF) (100% recommended level of nitrogen applied at 80% ETc) exhibited the potential to conserve about 8.9–25.7% of total water applied, besides boosting crop yield by 37.2%. In conclusion, this study elucidated better crop and water productivity with subsurface drip followed by surface drip irrigation as compared to traditional surface flood irrigation and manual fertilizer application. Therefore, adoption of drip irrigation systems for water and nitrogen application needs to be advocated for sustainable cotton cultivation.

Pod borer [Helicoverpa armigera (Hubner)] is a major biotic constraint to global pigeonpea production. The farmers largely apply synthetic insecticides to control this pest in pigeonpea. The study was conducted to quantify yield losses and estimate economic thresholds for H. armigera. The late maturing cultivar, IPA-203 was infested with different larval densities to determine the insect density-yield loss relationships. The yield response was variable and grain yield declined with increasing larval density from 1–5/plant. Yield loss of 4.56 kg/ha was evident for each unit increase in larval population. Economic threshold estimates indicated that the control measures for pod borer in IPA 203 cultivar should be initiated at an insect density of ≈1 larva/2 plants or at 3% pod damage to avoid the economic crop losses. The damage potential and economic threshold estimates are prerequisite for integrated pest management and reducing production costs (Alves et al. 2017). Present results indicated that relatively low infestations of H. armigera can cause significant yield reduction in pigeonpea hence intensive monitoring and timely control measures are necessary. Based on present economic threshold estimates, the farmers could decide the timing and kind of control measures to be initiated against pod borer in late pigeonpea cultivars to avert the economic losses.

Introduction Biallelic PDX1 variants are a rare cause of isolated pancreatic agenesis and neonatal diabetes (NDM) without exocrine pancreatic insufficiency, with 17 cases reported in the literature.Research design and methods To determine the phenotypic variability caused by this rare genetic aetiology, we investigated 19 individuals with NDM resulting from biallelic disease-causing PDX1 variants.Results Of the 19 individuals, 8 (42%) were confirmed to have exocrine insufficiency requiring replacement therapy. Twelve individuals (63.2%) had extrapancreatic features, including 8 (42%) with conditions affecting the duodenum and/or hepatobiliary tract. Defects in duodenum development are consistent with previous Pdx1 ablation studies in mice which showed abnormal rostral duodenum development.Conclusions Our findings show that recessive PDX1 variants can cause a syndromic form of NDM, highlighting the need for clinical assessment of extrapancreatic features in individuals with NDM caused by PDX1 variants.

Objective To describe antibiotic prescribing practices using the WHO AWaRe (Access, Watch, Reserve) classification in West African children under 5 years of age attending public primary health centres (PHCs).Design Cross-sectional study.Setting The AIRE project implemented the systematic use of pulse oximetry into integrated management of childhood illness consultations in West African countries (Burkina Faso, Guinea, Mali and Niger). We described antibiotic prescriptions for outpatient children at 16 PHCs and for severe cases referred at district hospitals.Patients Between 14 June 2021 and 19 June 2022, 15 854 outpatients were included: 968 neonates and young infants (0–28 days) and 14 886 children (2–59 months). Among them, 78 (8.1%) neonates and young infants and 385 (2.6%) children were hospitalised. We evaluated 58 hospitalised neonates and young infants and 275 hospitalised children, respectively.Main outcome measures Frequency of antibiotic prescriptions according to the AWaRe classification recommended by WHO.Results At the PHC level, proportions of neonates and young infants with ≥1 antibiotic prescription were 83%, 62%, 71% and 59% in Burkina Faso, Guinea, Mali and Niger, respectively. A total of 805 antibiotics were prescribed (85% Access and 13% Watch). The proportions of children with ≥1 antibiotic prescription reached 71%, 66%, 63% and 36% in Burkina Faso, Guinea, Mali and Niger, respectively. Out of the 9630 antibiotics prescribed, 93% were Access (mainly amoxicillin), and 7% Watch. At the hospital level, Watch antibiotics were mainly prescribed for severe cases referred. No Reserve antibiotics were prescribed.Conclusions High proportions of antibiotics were prescribed to outpatient children included, the appropriateness of which needs further study. Nevertheless, in every country, the proportion prescribed in the Access group reached the minimum threshold of 60% of all antibiotic prescriptions, as recommended by WHO.Trial registration number PACTR202206525204526.

Introduction Tuberculosis (TB) continues to be one of the deadliest infectious diseases over the centuries, killing more people worldwide than any other single infectious disease. There is an urgent need for additional strategies which can expedite efforts to combat TB including a preventive vaccine. In this endeavour, we have developed a protocol for a multisite, double-blind, placebo-controlled clinical trial in India that aims to evaluate the efficacy and safety of two TB vaccines; namely, VPM1002 and Immuvac (M.w) (Mycobacterium Indicus Pranii) (MIP) among healthy household contacts (HHCs) of sputum smear-positive pulmonary TB (PTB) patients.Methods and analysis In the three-arm randomised double-blind placebo-controlled trial study protocol, a total of 12 000 HHCs (aged 6−99 years) of sputum smear-positive PTB patients will be randomised to receive either of the two vaccine candidates VPM1002 and MIP or placebo. The primary efficacy endpoint is the prevention of microbiologically confirmed TB. Secondary endpoints will include (1) prevention against Latent TB infection, (2) incidence of adverse events and serious adverse events in study participants, (3) efficacy of vaccine in prevention of PTB/extra PTB in different age groups (6–18 years, 19–35 years, 36–60 years and above 60 years) and (4) immunogenicity of VPM1002 and MIP at month 2 and month 6 after first vaccination in terms of flow cytometric analysis of M.Tb specific CD4+ and CD8+ T cells secreting cytokines and Luminex assays for the presence of different cytokines in the sera and supernatants of peripheral blood mononuclear cells cultures stimulated with whole cell lysates of M.Tb and subsequently similar analysis for the cases who develop TB postvaccination during the follow-up period.Ethics and dissemination Ethics committees’ approvals have been granted by the Institutional Human Ethics Committees of all participating centres in this study and the names of the ethics committees and approvals are as follows: (1) National Institute for Research in Tuberculosis (NIRT)-Chennai (including subsites): ECR/135/Inst/TN/2013/RR-19, Approval No. 390/NIRT-Institutional Ethics Committee (IEC)/2018 dated 5 December 2018 (NIRT-Madurai-ECR/1365/Inst/TN/2020; approval dated 8 June 2020; NIRT, Vellore: ECR/1215/Inst/TN/2019; approval dated 26 September 2020); (2) All India Institute of Medical Sciences (AIIMS), Delhi (including subsites)-Institute Ethics Committee, ECR/547/Inst/DL/2014/RR-17 ECR/538/Inst/DL/2014/RR-20; approval No.IEC-385/06-07-2018, approval OP-28/05.04.2019 and SFH- ECR/593/Inst/DL/2014/RR-20 IEC/VMMC/SJH/project/2019-05/25 ; 23 May 2019; (3) National Institute of Tuberculosis and Respiratory Diseases (NITRD), Delhi: ECR/315/Inst/DL/2013/RR-19; approval IEC-No-NITRD/EC/2019/9004; 8 January 2019; (4) Pune-National AIDS Research Institute (NARI) and subsite-ECR/23/Inst/MH/2013/RR-19; IEC-NARI/EC/approval/2018/196; 29 May 2018; (5) Regional Medical Research Centre-Bhubaneshwar-ECR/911/Inst/OR-2017/RR-21; approval, dated 25 April 2018; Subsites- AIIMS, Bhubaneshwar ECR/534/Inst/OD/2014/RR-17 and 20 approval No. T/EMF/Pulm. Med/19/01 dated 13 May 2019; SCB, Cuttack No. No.ECR/84/Inst/OR/2013/RR-20; approval no.186 dated 7 February 2020; (6) NTI-Bengaluru: Ethics Committee-No-ECR/1819/Inst/KA/2019; approval No NTI-IEC/1.2019/principal investigator, dated 31 January 2019; (7) BMMRC, Hyderabad- ECR/450/Inst/AP/2013/RR-16 approval No. 779/BMMRC/2018/IEC, dated 11 June 2018 (Subsite Share India- Mediciti Ethics Committee-ECR/283/Inst/AP/2013/RR-20; Approval no. EC/11/VII/2K20(1) dated 11 July 2020) and (8) SJMC-Bengaluru: ECR/238/Inst/KA/2013/RR-19; approval IEC/1/491/2020; 7 August 2020.The trial findings will be published in accordance with the Consolidated Standards of Reporting Trials guidance. The results of this clinical trial will be presented at scientific conferences and disseminated through publications in peer-reviewed journals, conference presentations and shared with Ministry of Health and Family Welfare, policy-makers and other stakeholders.Trial registration number CTRI/2019/01/017026.

Introduction: Safe disposal of feces is ensured when it is deposited into a toilet, whereas unsafe disposal of child's feces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. Objective: To determine the effect of positive deviance (PD) approach on safe disposal of child's feces among households who owned a toilet. Materials and Methods: A community-based quasi-experimental study was conducted in the four field practice villages of the Urban Health Training Center, Villupuram, for 18 months. Households who owned a toilet and had a child less than 5 years old were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for 6 months to promote safe disposal practices in the study villages. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 24). The Chi-square test was used to determine the significance of difference between baseline and endline data. The effect size was calculated to estimate the magnitude of difference between baseline and endline data. Results: Before intervention, only 3% of households disposed the feces into a toilet, while after intervention, almost 38% of households disposed in the toilet (χ2 = 37.39; df = 1; P = 0.001). The effect size (Cramer's V) was found to be 0.43. Conclusion: PD approach demonstrated considerable improvements in safe disposal of child's feces in rural settings. Further, to sustain the behavior change, frequent reinforcement of key messages at frequent intervals needs to be emphasized.

Abstract Background It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities. Methods We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach’s alpha, assessed the questionnaire’s validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms. Results The questionnaire was found to be reliable in assessing HCWs’ knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach’s alpha = 0.9), but not heat strain symptoms (Cronbach’s alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p

Purpose: Oral candidiasis is one of the most common fungal opportunistic infections in the mouth caused by a fungus called Candida, and it presents as commensals in all humans. Over the last few decades, the increasing incidence of Candida infections parallels the growing numbers of immunocompromised patients. This trend is aggravated by the fact that there is a reckless use of antifungals. To combat this trend, the use of natural antifungals which have fewer side effects is recommended. Black grape seed extract (GSE) has shown a promise in this regard. Materials and Methods: Candida species such as Candida krusei, Candida glabrata, Candida tropicalis, and Candida albicans were used in the study. Fungal strains were passaged in the agar Sabouraud dextrose environment from 24 h to have live and fresh strains for the test. Black GSE was obtained. Minimum inhibitory concentration (MIC), of GSE, amphotericin B and fluconazole drugs on the included fungi was examined using disc diffusion method. Then, the plates were incubated for 24 h at 37°C. Finally, growth inhibitory zone was examined. Results: The analysis of the results revealed that the growth of C. albicans and C. krusei had been stopped at the concentration of 6.25 μg/mL, but the growth of C. glabrata and C. tropicalis was inhibited at a concentration of 12.25 μg/mL and 0.8 μg/mL respectively. Conclusion: The results obtained from the present study showed that both disc diffusion method and the maximum inhibitory concentration of MIC (Macro dilution) confirms the antimicrobial susceptibility of four species of candida to GSE. We conclude the possibility of GSE as an effective alternative measure for commercial antifungal agents, especially among immunocompromised patients, However, more laboratory and clinical studies need to be conducted to validate our findings.

Acute fibrinous and organizing pneumonia (AFOP) is a very rare form of acute or subacute lung injury, which is characterized by patches of fibrin deposits within the alveoli. There are no typical clinical features, and hence, it is often misdiagnosed as pneumonia, tuberculosis, or acute lung injury. A definitive diagnosis is obtained from a lung biopsy. AFOP responds to corticosteroids. Here, we present a case of AFOP and discuss the clinical manifestations, radiological findings, and management.

Background: In the past two decades, the growing economy associated with changes in lifestyle-related behavior is partially responsible for the increasing cancer burden in India. To assess the occurrence and distribution of oral cancer based on the analysis of hospital records from registered oncology institutes of South India over a period of three years. Materials and Methods: A multicenter, retrospective study was conducted at seven major hospitals in South India to assess the incidence and distribution of cancer among patients over a period of three years (2016–2018). Data were collected on a custom-made validated proforma. Analysis was done using R commander software. Results: A total of 156090 various types of cancers were reported to the included institutes over a three-year period, an almost similar gender distribution was observed, males (n = 78806, 42.99% per lakh) compared to their female counterparts (n = 77284, 42.16% per lakh). Among males' lung cancer was the most common type with 17709 cases (9.65% per lakh) and among females, breast cancer was the leading cancer type with 22855 total cases (12.46% per lakh). Over a period of three years, a total of 21084 records of malignancies pertaining to oral cavity were identified accounting for 13.51% of cases. Among oral cancers, tongue was the most common site to be involved accounting for 44.22% (2016–2018) cases followed by buccal mucosa (14.69%), least common site to be involved was lip which accounted for 3.49% of the total oral cancer cases. Conclusion: Breast cancer was the most common cancer followed by lung cancer. Oral cancers occupied second among males and fifth rank in the order of occurrence among females. Tongue was the most common site followed by buccal mucosa. The least common site affected by oral cancer was the lip.

Bargur, the hill cattle of Tamil Nadu, India is reared mostly inside the forests and is surviving under zero-input conditions. Their home tract is restricted to a narrow geographical area in and around Bargur hills at an elevation of about 1000 m above the MSL. The distinguishing morphological features of these cattle include its typical brown colour with white patches and being compact in size. The average body length, height at withers and heart girth were 99.7-2.0 cm, 10836+0.8 cm and 139, 92+0.9 cm in cows and 109.18-32 cm, 117.59-1.5 cm and 152.7+3.2 cm for adult males respectively. Cows are poor milkers and produce about 0.5 to 3.0 litres milk per day after suckling by calf. However, bullocks are famous for their endurance and speed in trotting. Animal are mostly maintained for dung and draft in the breeding tract. In the last three decades, the population of these animals has declined drastically by about 90% (to less than 10,000) due to various reasons. There is a strong and urgent need to make efforts for conservation so that the extinction of this valuable germplasm may be avoided.

Background Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.Objectives To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.Methods In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health.Results From a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86).Conclusion Patients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need.Trail registration number ISRCTN10980107.

The present study was carried out during 2019–20 and 2020–21 at the research farm of ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan to scale out the conservation agriculture (CA) practices in Indian mustard [Brassica juncea (L.) Czern.]-based cropping systems for enhancing production and farm profitability. Experiment was conducted in the split-plot design (SPD) after randomization, and replicated three times in the permanent plots. The treatment comprised of 3-tillage and crop residue re-cycling [permanent beds with residue (PB+R); zero tillage with residue (ZT+R); and conventional tillage without residue (CT-R)] in main-plots; and 6-oilseed brassica-based cropping systems [Fallow-mustard (F-M); Cluster bean [Cyamopsis tetragonoloba (L.) Taub.]-mustard (CB-M); Greengram [Vigna radiata (L.) R. Wilczek-mustard (GG-M); Maize (Zea mays L.)-mustard (Mz-M); Pearl millet [Pennisetum glaucum (L.) R. Br.]-mustard (PM-M); and Sesame (Sesamum indicum L.)-mustard (S-M)] in sub-plots. The mean mustard seed yield increased 28 and 11% under permanent beds with residue (PB+R) and zero tillage with residue (ZT+R) compared to conventional tillage without residue (CT-R), respectively. The mean seed yield of kharif crops also increased by 37.1 and 31.7% in the PB+R and ZT+R compared to CT-R, respectively. The maize-mustard (Mz-M) cropping system recorded significantly higher yield of mustard across the years followed by greengram-mustard (GG-M) cropping system. The mean mustard equivalent yield (MEY) increased by 33.4 and 24.2% in PB+R and ZT+R over the CT-R, respectively. The total system grain yield (TSGY) also increased by 29.6 and 14.7% in the PB+R and ZT+R over the CT-R, respectively. Among the cropping systems, GG-M followed by Mz-M system recorded highest MEY and TSGY in both the years. The Mz-M cropping system under PB+R recorded maximum net returns and B:C ratio which was higher by 40.7 and 41.1 compared to traditional F-M cropping system under CT-R, respectively. Thus, CA-based Mz-M/GG-M system should be out scaled in the traditional rainfed mustard based production system to improve the farm production and income on holistic basis to increase the edible oil production in the country.

Marigold (Tagetes spp.) belongs to family Asteraceae, native to Mexico, is one of the most important flower crop grown commercially in different parts of India. The application of haploid techniques as anther culture can considerably accelerate marigold breeding programmes by providing homozygous doubled haploid (DH) lines for F1 hybrid seed production. Therefore, the objective of the present investigation was to study the effect of growth regulators for in vitro regeneration in both African marigold and French marigold genotypes viz., Pusa Basanti Gainda and Pusa Arpita, respectively for haploid induction. Among the different treatments tested for callus induction, anthers cultured on MS medium supplemented with 1.0 mg/l BAP + 1.0 mg/l 2,4-D + 45 g/l sucrose significantly induced highest (38.74%) callus in the shortest period of time (16 days). Among two genotypes tested, embryogenic callus induction (27.70%) was significantly higher in Pusa Arpita over Pusa Basanti Gainda (23.37%). Among the different regeneration treatments, the highest adventitious shoot bud induction (13.32%), maximum (1.09) number of buds/callus in shortest duration (19.47 days) was observed in anther derived callus cultured on MS medium supplemented with 2.0 mg/l BAP + 0.5mg/l NAA + 30 g/l sucrose. Among two genotypes evaluated for shoot bud induction, maximum (3.81%) regeneration was recorded in Pusa Arpita over Pusa Basanti Gainda (2.90%). In French genotype, the whole regeneration process was completed in 30 days whereas in African genotype it took nearly 40 days. This rapid regeneration system from anthers is highly useful in inducing haploids and di-haploids in African and French marigold lines, respectively.

Yellow stem borer [Scirpophaga incertulas (Walker)], is a major pest of low-land rice (Oryza sativa L.), causing 30–40% yield losses. The use of biological control agents to suppress yellow stem borer (YSB) population and damage across Asia includes inundative releases of the egg parasitoid, Trichogramma japonicum Ashmead. However, information on the time and number of parasitoids’ releases are lacking to control YSB in summer low-land rice. Therefore, an experiment was conducted during summer seasons of 2018 and 2019 at ICAR-National Institute of Biotic Stress Management, Raipur, Chhattisgarh to standardize the time and number of T. japonicum releases for effective biocontrol of YSB. Experiment consisted of 3 different treatment schedules, viz. T1, Four releases of T. japonicum at weekly intervals on the 7th, 14th, 21st, 28th days after planting (DAT); T2, Four releases of T. japonicum at weekly intervals on the 14th, 21st, 28th, 35th DAT; T3, Four releases of T. japonicum at weekly intervals on the 21st, 28th, 35th, 42nd DAT; and T4, Control (no release of wasps). Significant reduction of YSB-induced damage symptoms was observed in the treatment schedule (T2) consisting of four releases of T. japonicum (@50,000 wasps/ha/release) at weekly intervals on the 14th, 21st, 28th, 35th DAT of rice which significantly reduced the dead heart (9.1%, 45.83% reduction over control) and the white ear (1.8%, 47.05% reduction over control), as compared to untreated control plots (T4) (16.8% dead heart, 3.4% white ear) in summer 2018. Similarly, in summer 2019, the reduction in dead heart and white ear by the treatment (T2) was 43.35% and 46.15% over control, respectively. The significant reduction of YSB-induced damages corresponded with the increased grain yield in (T2) from 2018–19 i.e. 12.74–20.18% across the seasons. The results suggest that the (T2) augmentative releases provided ecologically viable bio-control of YSB during the summer seasons in low-land rice.

This study examines the impact of access to India’s farm science centers (Krishi Vigyan Kendras, or KVKs) on agricultural households’ welfare using household data from the nationally representative Situation Assessment Survey of Agricultural Households conducted by India’s National Sample Survey Office in 2013. Employing different matching techniques and endogenous switching regression models, it was observed that the KVKs have a positive and statistically significant impact on agricultural households’ economic welfare, although, that impact is heterogeneous. Further, the investments made in expansion of India’s network of KVKs have been quite remunerative, as the benefit- to-cost ratio of expenditure on KVKs ranges from 8–12. Moreover, present findings suggest that expanding rural formal credit markets and promoting literacy can maximize the potential impact of KVKs on agricultural households’ economic welfare.

Abstract Background Textbook outcome (TO) is a composite measure reflecting various aspects of services provided to patients with solid malignancies. We sought to evaluate the importance of various TO components previously proposed for gastric cancer. Methods Prospectively maintained electronic databases of 1,743 patients treated in two academic surgical centres were reviewed. Six candidate definitions of TO were evaluated based on their ability to accurately predict patients’ prognosis by Cox proportional hazards modelling. Results TO definition combining 10 measures corresponding to complete tumour resection with an uneventful postoperative course showed the best goodness of fit by achieving the lowest values of Akaike (AIC) and Bayesian (BIC) information criteria and the best predictive performance based on the highest value of c-index. The overall median survival was significantly longer for patients with than without textbook outcome (69.0 vs 20.1 months, P

BACKGROUND: Flipped classroom (FC) teaching has recently received much attention in medical education. It has been introduced in our institution for 2 years, and we studied the effectiveness and perception of FC teaching in Physiology for first-year undergraduate students. MATERIALS AND METHODS: In total, 150 out of 250 first-year MBBS students participated in this study. They were divided into two groups, each consisting of 75 students. Multiple topics in the cardiovascular system were taught to the students by employing traditional classroom (TC) didactic lectures in group A. The same topics were handled using FC in group B, where the students came prepared with the study materials the facilitator provided before class commenced. A well-planned classroom discussion with a formative assessment was conducted at the end. The test scores were compared between the two groups by using an independent t-test. A feedback report was obtained from both groups’ students to analyze the teaching-learning methods’ accomplishment. RESULT: FC teaching scores were significantly higher than the traditional lecture among all students. Feedback results showed that 93% of students agreed that the resource materials, group discussions, videos, and exercise tools used in FC were very useful; 95% of students agreed that it provided a good understanding and better appreciation of basic science knowledge in health and disease, and 91% reported that it was well-organized with good interaction, clear explanation, relevant information, and encouraged critical thinking with active student participation. CONCLUSION: FC proves to be an effective, interesting, and motivating teaching-learning module. It enhances communication skills, clinical thinking, interaction, and active student participation.

The experiment was conducted during 2019 and 2020 at the Instructional-cum Research (ICR) Farm, Assam Agricultural University, Jorhat, Assam to study the impact of different combinations of organic nutrient sources on aromatic rice (Oryza sativa L.) (rainy-kharif) and their residual effect on linseed (Linum usitatissimum L.) (winter- rabi) crop for developing a double cropping sequence for rice growers of Assam with organic management. The experiment comprised three aromatic rice cultivars, viz. Kola joha, Keteki joha and Chakhao poireiton and five combinations of organic nutrient sources. Out of the organic nutrient sources, application of N @30 kg/ha through vermicompost along with pre-season green manuring of Sesbania bispinosa and root dip treatment of rice seedlings with Azospirillium and phosphorus solubilising bacteria @3.5 kg/ha each (N3) resulted the highest number of panicles/ m2 (216.72 in 2019 and 223.96 in 2020), highest yield of rice (30.26 q/ha in 2019, 32.58 q/ha in 2020 grain yield and 65.99 q/ha in 2019, 68.98 q/ha in 2020 straw yield). The highest seed yield (394.52 kg/ha in 2019, 416.97 kg/ha in 2020) and stover yield (890.09 kg/ha in 2019, 896.63 kg/ha in 2020) of succeeding relay sown linseed were recorded with the N3 treatment. The highest available N (250.10 kg/ha), P2O5 (20.40 kg/ha) and K2O (140.06 kg/ha), organic C (0.65%), soil organic carbon (SOC) stock (13.29 t/ha), soil microbial biomass carbon (SMBC) (183.43 µg/g of soil) in soil were recorded with the N3 treatment after harvest of linseed in 2020. The study affirmed the suitability of rice-linseed cropping sequence for efficient utilization and conservation of resources.

The growth and productivity of cotton (Gossypium herbaceum L.) crop are greatly influenced by major fluctuations in the local weather. The output of cotton is negatively impacted by extended periods of unfavourable weather, despite the crop's apparent relative resistance to heat and drought. Among various cotton growing states in India, Gujarat often leads as the highest cotton-producing state in the country followed by Maharashtra, Telangana, Rajasthan, Karnataka and Andhra Pradesh. These states collectively contribute more than 65% to India's cotton production. In Punjab, the optimal sowing window for cotton spans from the 1stApril to 15th May. Deviating from this recommended time frame, be it through excessively early or late sowing, correlates with compromised crop establishment and reduced productivity. Temperature thresholds dictate progression of the cotton crop's key stages. For germination, a threshold temperature of 16°C is required, while the range of 21 to 27°C is conducive to vegetative growth, and 27 to 32°C supports reproductive development. The diurnal/night time temperature for fostering cotton root growth resides within 30°C/22°C to 35°C/27°C. Elevated temperatures (40°C/32°C), even under adequate water and nutrient conditions, results in the emergence of shallow root systems. Strategic measures encompassing suitable sowing dates, precise plant spacing, favourable row orientations, judicious irrigation techniques and mulching can effectively temper the influence of climate change on cotton output. Furthermore, the application of crop simulation models and access to timely, accurate weather forecasts and agro-advisories equips decision-makers with invaluable insights for short-term operational planning.

The nucleus preserves the genomic DNA of eukaryotic organisms and maintains the integrity of the cell by regulating the transport of molecules across the nuclear membrane. It is hitherto assumed that small molecules having a size below the passive permeability limit are allowed to diffuse freely to the nucleus while the transport of larger molecules is regulated via an active mechanism involving energy. Here we report on the kinetics of nuclear import and export of dextran molecules having a size below the passive permeability limit. The studies carried out using time-lapse confocal fluorescence microscopy show a clear deviation from the passive diffusion model. In particular, it is observed that the steady-state concentration of dextran molecules inside the nucleus is consistently less than the concentration outside, in contradiction to the predictions of the passive diffusion model. Detailed analysis and modeling of the transport show that the nuclear export rates significantly differ from the import rates, and the difference in rates is dependent on the size of the molecules. The nuclear export rates are further confirmed by an independent experimental study where we observe the diffusion of dextran molecules from the nucleus directly. Our experiments and transport model would suggest that the nucleus actively rejects exogenous macromolecules even below the passive permeability limit. This result can have a significant impact on biomedical research, especially in areas related to targeted drug delivery and gene therapy.

Resistance of antibiotics towards pathogenic microorganisms has led to the continuous search of natural plant products as a potential alternative for synthetic antibiotic agents. Many plant produces have shown promising results towards this end. This has led to commercialization and packaging of plant produce especially fruits. However, much research needs to be conducted to assess the potential benefits of commercially available plant produce compared to the natural ones. Consumable food items have both positive and bad effects, and their antibacterial effects on various microorganisms found in the oral cavity are good. To comparatively evaluate the effects of fresh fruit extracts and commercially available juice of Apple, Guava and Pomegranate on the growth of Streptococcus mutans. The present study describes the antibacterial activity of three selected fresh fruit extract and their commercial counterparts (Apple, Pomegranate and Guava) on Streptococcus mutans. Antimicrobial activity of fruit juices (fresh and commercial) was tested by well diffusion assay by an inhibition zone surrounding the well. The aim of the study was to comparatively evaluate the antibacterial activity of three fruit juices on Streptococcus mutans. Analysis of the results revealed the highest antibacterial activity for Fresh fruit extract of Guava towards Streptococcus mutans with a mean diameter of inhibition zone (DIZ) value of 11.26 ± 0.53(P>0.01) and the least was exhibited for commercial juice of pomegranate with a mean diameter of inhibition zone (DIZ) 2.20 ± 0.25 (P>0.01). The results obtained in this study clearly demonstrated a significant antimicrobial effect of fresh fruit extract of guava against Streptococcus mutans. However, preclinical and clinical trials are needed to evaluate biocompatibility and other effects, but in vitro observation of fresh fruit extracts of selected fruits appears promising. Keywords: Antimicrobial, Fruit Juice, Microorganism, Agar well diffusion method, Apple (Malus domestica), Psidium guajava, Pomegranate (Punica granatum)

Essential oils are plant-derived aromatic volatile oils, and they contain bioactive compounds that have been shown to improve poultry nutrition. However, considering problems associated with the solubility and bioavailability of polyphenolic compounds, the study was planned to find out the effect of the novel feed-grade delivery system, phytosomes for conjugation of plant-derived polyphenolic compound carvacrol on the growth performance of broiler chickens. The experiment was conducted, on 240 broiler chicks for a period of 6 weeks. The chicks were divided into 4 groups having 4 replicates of 15 birds each. The birds in the control group (T0) offered a standard diet as per BIS (2007) specification. Group T1 received a standard diet supplemented with Bacitracin Methylene Disalicylate (BMD) antibiotic at standard dose and group T2 received a standard diet supplemented with carvacrol essential oil @100 mg/kg feed. Group T3 received a standard diet supplemented with phytosome-conjugated carvacrol essential oil (carvacrol @16.6%) @100 mg/kg feed. The performance of all the treatment groups was assessed with respect to the different performance parameters. The supplementation of phytosome-conjugated carvacrol essential oil (carvacrol @16.6%) @ 100 mg/kg feed was found beneficial in terms of growth performance, feed efficiency, and intestinal morphometry. In terms of economics of broiler production, the results revealed that the addition of phytosome- conjugated carvacrol essential oil and carvacrol essential oil in diets was found beneficial in reducing the cost of broiler production, thereby enhancing the margin of profit in broiler production and fetching higher net profit than the control group.

In the urban scene segmentation, the "image-to-image translation issue" refers to the fundamental task of transforming input images into meaningful segmentation maps, which essentially involves translating the visual information present in the input image into semantic labels for different classes. When this translation process is inaccurate or incomplete, it can lead to failed segmentation results where the model struggles to correctly classify pixels into the appropriate semantic categories. The study proposed a conditional Generative Adversarial Network (cGAN), for creating high-resolution urban maps from satellite images. The method combines semantic and spatial data using cGAN framework to produce realistic urban scenes while maintaining crucial details. To assess the performance of the proposed method, extensive experiments are performed on benchmark datasets, the ISPRS Potsdam and Vaihingen datasets. Intersection over Union (IoU) and Pixel Accuracy are two quantitative metrics used to evaluate the segmentation accuracy of the produced maps. The proposed method outperforms traditional methods with an IoU of 87% and a Pixel Accuracy of 93%. The experimental findings show that the suggested cGAN-based method performs better than traditional techniques, attaining better segmentation accuracy and generating better urban maps with finely detailed information. The suggested approach provides a framework for resolving the image-to-image translation difficulties in urban scene segmentation, demonstrating the potential of cGANs for producing excellent urban maps from satellite data.

Paratuberculosis, caused by Mycobacterium avium subsp. paratuberculosis (MAP), is a significant concern in the camel population of Saudi Arabia. This study aimed to provide epidemiological insights into the disease by estimating the true prevalence in camels in the Eastern Province and Riyadh, using a Bayesian estimation framework, and exploring the associated risk factors through a frequentist approach. A total of 1200 camel blood samples were collected and analyzed using an indirect ELISA method. The true herd-level prevalence was estimated at 0.7 (95% probability interval: 0.57 to 0.81), and the mean expected true animal-level prevalence was 0.17 (0.14 to 0.20). Risk factors associated with Map seropositivity were identified, including sex, breed, raising system, and production type. Females, single breed camels, and nomadic raising systems were found to have lower odds of seropositivity, while camels used for racing and show had significantly higher odds. The study's Bayesian approach, adjusting for the imperfect accuracy of MAP tests, provides a nuanced understanding of the disease's prevalence in the region. The integration of true prevalence estimates with risk factor analysis offers a comprehensive framework that can guide future policies and strategies in the fight against paratuberculosis in Saudi Arabia. The findings emphasize the importance of targeted control measures, underscoring the urgent need for interventions in Saudi Arabia's camel population. By understanding the true disease prevalence and its associated risk factors, we can enhance disease management strategies, offering valuable insights for future control and eradication efforts in the region.

Introduction Income disparity is a huge issue in a country, majority of the poor people in our country is at the base of pyramid, richest being on the top. Government of India launched Janani Shishu Suraksha Karyakram (JSSK) scheme throughout country to further enhance the institutional delivery and reduce the out of pocket expenses.

Abstract Background Physical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD. Methods This was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM. Results 340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively. Conclusion Results from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD. Trial Registration NCT04872933. Registered 5th May 2021.

Several Psidium species are available with many important traits, lack of intensive characterization limits their use in guava improvement. Therefore, the present study was carried out to characterize five wild Psidium species (P. molle, P. chinensis, P. guineense, P. cattleianum var. cattleianum and P. cattleianum var. lucidum) and two P. guajava genotypes (cv. ‘Arka Poorna’ and ‘H 12-5’), based on morphological and biochemical traits. Among morphological traits, fruit weight was ranged from 5.22 g (P. cattleianum var. cattleianum) to 225.14 g (‘H 12-5’), however, among biochemical traits, highest TSS (12.06 ºBrix) and total sugars (9.98%) were recorded in cv. ‘Arka Poorna’, while, lowest recorded in P. cattleianum var. lucidum. Highest ascorbic acid was recorded in P. chinensis (205.33 mg/100 g), whereas, lowest recorded in P. guineense (60.83 mg/100 g). A positive correlation was observed among wild Psidium species but none had correlation with P. guajava genotypes for quantitative traits.

An experiment was conducted during the rainy (kharif) seasons of 2021 and 2022 at the Norman E. Borlaug (NEB) Crop Research Centre at Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, Uttarakhand to study the effect of different establishment methods and weed management practices on growth and yield of rice (Oryza sativa L.). The study was carried in a split plot design with 3 replications. In main plot 4 rice establishment methods and in sub plot 4 weed management practices were included. The results revealed that significantly higher grain yield was recorded in mechanical line sowing (S2) over rest of the treatment. According to the pooled data analysis of grain yield the per cent increase in mechanical line sowing (S2) over broadcasting (S1), raised bed system (S3) and semi-dry system (S4) was 23.1%, 17.6% and 8.1%, respectively. Among the different weed management practices grain yield was recorded maximum in W3 (pre emergence herbicide followed by two manual weeding) treatment which showed at par results with W2 (pre emergence followed by post emergence herbicide) treatment. The per cent grain yield increase in pre emergence herbicide followed by two manual weeding (W3) over manual weeding (W1), pre emergence followed by post emergence herbicide (W2) and mechanical weeding (W4) was 19.3%, 0.75% and 31.7%, respectively. Weed density was recorded minimum in mechanical line sowing (S2) and raised bed system (S3). At panicle initiation stage significantly lower weed density was recorded in mechanical line sowing (S2). However, among the weed management practices manual weeding (W1) and pre emergence herbicide followed by two manual weeding (W3) treatments recorded at par. Weed dry weight remain non-significant under different rice establishment methods during active tillering as well as panicle initiation stage.

The effect of feeding Lathyrus grain as substitute of GNC protein in the diet of lambs was studied for nutrient utilization, blood and rumen metabolites and growth performance. Jalauni lambs (n=18) weighing around 16.45±1.50 kg were randomly allocated into three dietary treatments in a completely randomized block design. In the control group (LG0), the animals were fed ad lib. green chaff of fodder Sorghum bicolor cv. M. P. Chari with concentrate mixture as per requirement whereas in the LG50 and LG100, the crude protein of groundnut cake was replaced @50% and 100% with Lathyrus grain (LG) protein in the concentrate mixture, respectively. Supplementation of LG did not influence the total DMI (g/day) in animals of different experimental groups. Digestibility(%) of DM, OM, and cell wall polysaccharides (NDF, ADF, cellulose) was also comparable amongst the different dietary groups, while CP digestibility was higher in LG50 group than LG0 or LG100 group. Digestible crude protein (DCP) content was higher in LG50 than LG0 or LG 100 whereas total digestible nutrients (TDN) contents were comparable amongst the treatment groups. Similarly, rumen metabolites and all the blood parameters were comparable among the groups and within the normal physiological range. The daily body weight gain was not affected with the experimental diets. It could be concluded that Lathyrus grain could be used as an alternative source of protein in the concentrate mixture without any adverse impacts on nutrient utilization, rumen fermentation, blood metabolites and growth performance of Jalauni lambs.

Background: Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infancy in which the pyloric portion of the stomach becomes hypertrophied, leading to obstruction of gastric emptying. Various approaches have been tried for surgical management of IHPS. The first successful surgery was performed by Dufour and Fredet in which the hypertrophic pyloric muscle is longitudinally splitted and closed transversely. However, Ramstedt introduced extramucosal pyloromyotomy, introduced in 1912 which still remains the gold standard for surgical management of IHPS. Later on, in 2009, Alayet et al. introduced a new technique known as Alayet's double-Y (DY) pyloromyotomy which he claimed to have a better functional outcome compared to Ramstedt's pyloromyotomy (RP) while maintaining a safety profile similar. The objective of this study was to compare the outcome of surgical management of IHPS between DY pyloromyotomy and Ramstedt's pyloromyotomy. Materials and Methods: It was a prospective study conducted in the Paediatric Surgery Department of SVPPGIP, SCB Medical College, Cuttack, from January 2019 to April 2022. All the IHPS cases were admitted and optimised thoroughly with regard to hydration, acid-base status and electrolyte imbalance. We have included 60 patients and were divided into two groups; every alternate patient was pooled into one group. Detailed and informed consent was taken from parents regarding the surgical procedure of their baby. The patients were selected alternatively, i.e., if one patient underwent Ramstedt's pyloromyotomy then in the next patient Alayet's DY pyloromyotomy procedure was done. The demographic characteristics of all patients, operative procedure performed, duration of surgery, intraoperative anaesthesia or surgical complication, post-operative vomiting patterns and weight gain data were collected and analysed in Microsoft Excel sheet and SPSS software. The student's t-test was used to compare both groups. Results: We found that both groups were similar while considering the demographic characteristics as there were no significant statistical differences noticed in the patient population with regard to age (DY Group 42.73 ± 9.01 days vs. RP Group 40.63 ± 7.6 days; P = 0.8209), sex (DY 4F/26M vs. RP 6F/24 M), weight at presentation (DY 3.3 ± 0.33 kg vs. RP 3.2 ± 0.21 kg; P = 0.33449), symptoms and clinical condition. All patients were optimally resuscitated before proceeding to surgery with regard to hydration, electrolyte imbalance and acid-base status. While considering anaesthesia, both groups were equal in terms of it and no anaesthesia-related complications were recorded in our study. However, during the first post-operative week, a significant difference was noted between DY versus RP groups with regard to vomiting (DY 1.33 ± 0.59 days vs. RP 2.8 ± 0.76 days; P = < 0.0001) and weight gain (299.86 ± 41.90 g vs. 199.03 ± 21.72 g; P = 0.008), respectively. Patients were followed up for 6 months post-operatively. No long-term complications were noticed in both groups. Weight gain after 1 month DY 577.46 ± 169.96 g versus RP 574.70 ± 170.10 g, (P = 0.949969), after 2 months DY (758.43 ± 94.53 g vs. RP 758. 8 ± 94.68 g, P = 0.98699) and after 3 months DY (593 ± 20.01 g vs. RP 591.16 ± 20.89 g, P = 0.61136). Overall, the operative time duration was the same in both groups. We had not noticed any intraoperative complications, post-surgical site infections were encountered. There was no need to redo pyloromyotomies in our study. Conclusion: Our study demonstrated that the double-Y pyloromyotomy procedure provides a better functional outcome with regard to vomiting and weight gain in the early post-operative period. It seems to be due to the wider opening of the pyloric canal at both ends of pyloromyotomy incision with a wide angle compared to Ramstedt's pyloromyotomy. Obviously, the chance of mucosal perforation is also less as the enforce of the mucosa is divided into two directions. The method is suitable for both conventional and laparoscopic surgery. The small sample size was a limiting factor in this study. However, more studies need to be done on this technique to prove its efficacy and establish it as a standard technique for the future.

Aim: This article aimed to present the salient features of the in-house developed Java program for the determination of inflection point and dosimetric parameters of flattening filter-free (FFF) photon beam. Reference levels for the dosimetric parameters of the FFF photon beams were also presented. Materials and Methods: Beam profiles of 6 MV FFF and 10 MV FFF photon beams for a collimator setting of 20 cm × 20 cm measured at 10 cm depth in an isocentric setup acquired from various institutions were analyzed using an in-house developed Java program and manual method. The values of reference dose value (RDV), field size, penumbra, and degree of un-flatness (defined as the lateral separation between 90% [X90%], 75% [X75%], and 60% [X60%] dose points on the profile) were calculated and compared. The reference values of field size, penumbra, and degree of un-flatness were also determined for Varian and Elekta medical electron linear accelerators (LINACs). Results: The maximum differences for RDV determined using the Java method and manual method are 2.4% and 2.7% for 6 and 10 MV FFF photon beams, respectively. The maximum difference between the values of field size, penumbra, and degree of un-flatness determined using Java and manual methods is within 1.3 mm. The reference values of field size and penumbra for Varian LINACs are 19.94 ± 0.10 cm and 0.83 ± 0.08 cm (6 MV FFF) and 19.95 ± 0.10 cm and 0.83 ± 0.08 cm (10 MV FFF). Similarly, the reference values of field size and penumbra for Elekta LINACs are 20.02 ± 0.09 cm and 0.94 ± 0.12 cm (6 MV FFF) and 20.03 ± 0.11 cm and 0.97 ± 0.16 cm (10 MV FFF). Conclusions: A software program was developed in Java for analyzing the beam profiles of FFF photon beams. The results of Java-derived values of dosimetric parameters of FFF photon beams were found in good agreement with the values determined using the manual method. The reference values of these parameters were also derived and quoted using a large cohort of the data.

Purpose: To compare the efficacy of oral propranolol, oral rifampicin, and intravitreal anti-VEGF therapies on resolution-time and visual outcome in patients with central serous chorioretinopathy (CSCR). Methods: A total of 30 patients with CSCR were randomized into three groups of 10 patients. Group A was given oral propranolol, Group B was given oral rifampicin 4 weeks each, and Group C was given 0.05 ml intravitreal injection of anti-VEGF. Comparisons of mean BCVA, contrast sensitivity, and central macular thickness (CMT) performed between baseline and follow-up at 4 weeks, 6 weeks, and 3 months. Results: Statistically significant improvement in BCVA and contrast sensitivity was noted among all three groups. Complete resolution of SRF as indicated by CMT was seen at the end of 4 weeks in Group C, whereas there was a steady decline in CMT until 3 months in Groups A and B. Conclusion: Intravitreal anti-VEGF therapy shows a significantly faster SRF resolution. However, oral propranolol and oral rifampicin could prove as a useful, cost-effective treatment of CSCR.

Introduction: The present article aims to describe the experience of organizing a telepsychiatry program to ensure continuity of care during the COVID-19 pandemic from the doctors’ as well as the patients’ perspectives. Methods: We initiated a synchronous telepsychiatry program for continuity of care using a Government-sponsored online platform with facilities for consulting a psychiatrist and e-prescription. Three months later we conducted a Video Focus Group discussion (VFGD) among the doctors involved in the program and telephonic interviews with randomly selected patients and caretakers to evaluate the merits and demerits of the program and to elicit suggestions for improvement. Results: The online services were availed by 120 patients (55% males) with the majority in the 19-60 years age group; 47.5% of them were availing psychiatry consultation for the first time. Overall, depression and anxiety were the common diagnoses. Both doctors and patients felt that online services are feasible and acceptable, ensure adequate privacy and provide the opportunity to avail of mental health services without stigma. Conclusions: Telepsychiatry has the potential to develop into an alternate model of mental health service delivery and it is more advantageous to women, the elderly, and those with travel difficulties. Mental health support to people in prisons, government residential facilities, and geographically isolated areas through online platforms is a feasible and cost-effective option. Definite legal and ethical guidelines on telepsychiatry should be formulated with facilities for training for professionals. Online platforms should be more user-friendly and tailor-made to provide psychotherapy and counseling services in addition to pharmacotherapy.

In the present study, an attempt was made to develop an expert system for the diagnosis of cattle diseases under field conditions by Veterinarians. A questionnaire tool was developed and used for collecting the scores for symptoms or signs of 13 cattle diseases for diagnosis. The tool was tested for face validity by pilot survey with experts and content validity by calculating Aiken’s value index. The scores for the signs or symptoms were collected from 178 field veterinarians from different states in India. The scores obtained were tested for reliability and consistency by using the split-half test [88.7%] and Cronbach’s alpha coefficient [92.7%], respectively. The weighted matrix was calculated for the 51 signs or symptoms obtained for 13 cattle diseases. The CaDDES, a web application was developed using PHP, HTML, JavaScript, and MySQL computer programming languages. This web application contains Home, Introduction, About CaDDES, Disease Diagnosis, Development Team, and Contact pages. The Veterinarians need to enter the basic details of cattle and select the signs or symptoms observed in the particular cattle under field conditions. The results page will display the three probable diseases diagnosed for the selected signs or symptoms. Further, the necessary samples to be collected for laboratory confirmation and preventive measures to be undertaken were also provided. This web application will be useful for field level diagnosis of cattle diseases by Veterinarians and later by farmers. It may also be useful as a surveillance application, which will improve cattle disease reporting in the future.

A two-year field study was carried out during winter (rabi) seasons of 2020–21 and 2021–22 at the research farm of ICAR-Indian Agricultural Research Institute, New Delhi with the aim of examining the impacts of various methods of tillage, residue management and nitrogen (N) application on wheat (Triticum aestivum L.) yield, water use efficiency (WUE), and nitrogen use efficiency in terms of Partial Factor Productivity of Nitrogen (PFPN). The study utilized a split-split plot design with 3 replications, where the main plot consisted of two tillage systems [conventional tillage (CT) and no tillage (NT)], the subplot comprised 2 residue levels [maize residue @5 t/ ha (R+) and no residue (R0)], and the sub-sub plot involved 3 N levels [60, 120, and 180 kg N/ha, representing 50% (N60 kg N/ha), 100% (N120 kg N/ha), and 150% (N180 kg N/ha)] respectively. The results indicated that both tillage and residue management considerably influenced the grain and biomass yield of wheat. Over the two years, NT exhibited a 7% higher WUE compared to CT, but the change was insignificant. However, in years with lower rainfall, crop residue mulching had a significant positive impact on WUE, while in years with higher rainfall; its effect on WUE was insignificant. Moreover, tillage practices had a considerable effect on the PFPN. In the year 2020–21, PFPN under NT was 3.59% higher than under CT, and in the year 2021–22, it was 2.06% higher. Furthermore, with an increase in N levels, WUE showed a substantial increase, while PFPN decreased.

Objectives: Inotuzumab ozogamicin (InO), a CD22-directed antibody-drug conjugate indicated for relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukemia (ALL), is associated with hepatotoxicity and hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), particularly after post-hematopoietic stem cell transplantation (HSCT). In this sttudy, we evaluate HSCT outcomes in patients (pts) who received InO before HSCT. Materials and methods: This observational, post-authorization safety study included pts (>=18y) in the US with B-cell precursor ALL and R/R ALL who received InO and proceeded to first allogeneic HSCT. Post-HSCT outcomes included overall survival (OS), non-relapse mortality (NRM), relapse, and adverse events (AEs). Multivariate analysis examined prognostic factors for NRM and VOD. This final analysis is based om 5-y data. Results: 261 pts (median age 39y, 58% male) were evaluated: 36% in first complete remission (CR1), 46% in CR2, 11% in CR>=3, 4% in first relapse, 1% in >= third relapse, and 2% with primary induction failure. Prior to HSCT, 32%, 47%, 14%, 5% and Median time from last InO dose to HSCT was 2.5 mo. Post-HSCT 18-mo OS was 54% and 50% and 18-mo NRM was 22% and 25% for pts with ALL and R/R ALL respectively; most common causes of NRM were VOD (26%, 24%) and graft-versus-host disease (GVHD: 22%, 19%). AEs=30% of pts with ALL and R/R ALL respectively were bacterial infection (51%, 56%), viral infection (44%, 44%) and acute GVHD (grades II-IV; 43%, 41%). 35 pts with ALL developed VOD: 15 cases were mild, 20 were severe and 22 died = 3.3 mg/m2; and 15%, 2%, 17% and 14% in pts with time from las InO dose to HSCT of 1, 1.1-1.6, 1.7-4, and >=3 mo. 204 pts with ALL were included in multivariate analyses; Karnofsky score

Introduction: Concizumab is a humanised, recombinant monoclonal antibody administered to patients with haemophilia A/B with inhibitors (HAwI/HBwI) as a once-daily prophylaxis (PPX) in the phase 3 explorer7 study (NCT04083781). In the primary analysis, concizumab PPX reduced the annualised bleeding rate for patients with HAwI/HBwI. Subcutaneous (SC) administration of concizumab may contribute to a lower treatment burden compared to intravenous factor replacement therapy. Here, we present data from explorer7 on patient-reported treatment burden and patient preference. Methods: A total of 133 patients aged ≥12 years were either randomised 2:1 to concizumab PPX (arm 2; n = 33) or no PPX (arm 1; n = 19) or assigned to non-randomised concizumab PPX (arms 3 or 4; n = 81). Patients could complete the Hemophilia Treatment Experience Measure (Hemo-TEM) questionnaire at baseline (Week 0) and Week 24 and the Haemophilia Patient Preference Questionnaire (H-PPQ) at Week 24. Analysis of covariance was applied to estimate mean change in Hemo-TEM domain and total scores from baseline to Week 24. The H-PPQ results were analysed descriptively. Results: The Hemo-TEM total score improved with concizumab PPX (n = 19) from baseline to Week 24 (mean estimate -17.0 points [95% CI: -23.7; -10.3]), but not in patients with no PPX (n = 6, mean estimate 3.0 points [95% CI: -9.4; 15.3]). The estimated treatment difference in Hemo-TEM total score between both arms was statistically significant (-19.9 points [95% CI: -34.3; -5.6]; p = 0.009). Significant improvements in arm 2 were observed in the domains “injection difficulties”, “interference”, and “emotional impact”. In the H-PPQ questionnaire; 77/99 patients (78%) preferred concizumab over their previous treatment, while only one patient (1%) preferred their previous treatment (16 patients did not respond, and 5 patients had no preference). Of all responding patients, 93% preferred concizumab with the 3 main reasons being “fewer bleeds”(75%), “require less time”(43%), and “less painful to inject”(33%). Discussion/Conclusion: A lower treatment burden was observed for daily concizumab PPX with better Hemo-TEM domain and total scores. Lower treatment burden due to SC administration combined with reduced bleeding (especially in HBwI) resulted in a clear patient preference in favour of concizumab over their previous treatment.

An experiment was conducted during winter (rabi) seasons of 2020–21 and 2021–22 at Horticulture farm of Sri Karan Narendra Agriculture University, Jobner, Jaipur, Rajasthan to determine the effect of transplanting date, cultivar and zinc application method on growth, yield and quality of onion (Allium cepa L.). Experiment was conducted in split-plot design and replicated thrice. The treatments consist of 2 transplanting dates, viz. 10th December and 01st January; and 3 cultivars, viz. RO-01, RO-59 and Bhima Shakti were kept in main plot; and in sub- plots, 4 methods of zinc application, viz. control, soil application of ZnSO4 @25 kg/ha, dipping of onion seedlings in zinc solubilizer solution before transplanting and foliage spray of ZnSO4 @0.5% at 30 and 45 days after transplanting were kept. Significantly higher plant growth, bulb yield (416.8, 358.0 and 387.4 q/ha) and quality of onion were recorded in 01st January transplanting date. Among the cultivars, significantly higher plant growth, bulb yield (417.5, 358.4 and 388.0 q/ha) and quality of onion were recorded in Bhima Shakti but these parameters were at par with RO-59. In zinc application methods, significantly higher plant growth, bulb yield (41.5, 35.8 and 38.7 t/ha) and quality of onion were noticed under foliar application of ZnSO4 @0.5% but these were found at par with soil application of ZnSO4. Thus, the conclusion of findings was that the transplanting of Bhima Shakti cultivar on 01st January and with foliar application of ZnSO4 @0.5% had the potential effect to increase onion performance.

Purpose: Diabetic retinopathy (DR) is a leading cause of ocular morbidity. Its progression depends mainly on retinal vasculature and ocular blood flow. Color Doppler imaging (CDI) is a noninvasive imaging technique that measures blood flow velocity. The resistivity index (RI), calculated by the CDI, reflects the vascular resistance distal to the measuring location. RI is independent of the doppler angle and position of the patient, making it a reliable and reproducible parameter. To the best of our knowledge, there is only one study in literature studying the association between resistivity index (RI) of the central retinal artery (CRA) and severity of DR. Aim: To determine the association between RI of CRA and severity of DR. To determine the association between RI of CRA and spectral-domain optical coherence tomography (SD-OCT) biomarkers for DR. Methods: Type II diabetics visiting our OPD underwent DR screening and were graded into three categories according to ETDRS classification which include Group A—No diabetic retinopathy (No DR), Group B—Nonproliferative diabetic retinopathy (Moderate–Severe–Very Severe NPDR), and Group C—Proliferative diabetic retinopathy (PDR). SD-OCT was performed. Ultrasonic color doppler imaging was done. RI of the CRA was noted. It was compared between the three groups and its association with severity of DR and OCT biomarkers (central subfield thickness, cube average thickness and ellipsoid zone disruption) was studied. Results: 56 eyes of 28 patients were included in our study with 20 in Group A,14 in Group B, and 22 in Group C. RI of CRA compared within groups showed statistically significant association with severity of DR (P < 0.001). The presenting BCVA (LogMar) showed positive correlation with RI in all groups. OCT biomarker central subfield thickness showed a positive correlation with RI in Groups A (P < 0.001) and B. Ellipsoid zone (EZ) disruption showed a statistically significant association with RI in Group C (P < 0.001). Conclusion: The RI of CRA is a reliable biomarker for the assessment of the severity of DR. Patients with high RI of CRA had higher chances of EZ disruption and presented with poor visual acuity.

Background: Aging is a global phenomenon. Depression and loneliness among the elderly are significant mental health concerns, often overlooked and underestimated in society. Globally, depression amounts to a loss of 2% disability-adjusted life years. India is 2nd most populous in the world by elderly population, depression and loneliness are often overlooked due to various reasons. Therefore, this study aims to explore the proportion of depression and loneliness and to determine their association with loneliness and other sociodemographic factors. Methodology: A community-based cross-sectional study was conducted among 132 elders (age ≥60 years) in three wards of the urban area of Bengaluru. Geriatric Depression Scale 15 and Three-Item Loneliness Scale were used to assess depression and loneliness, respectively. The association between depression and loneliness was analyzed with other demographic variables using Chi-square and Bivariate logistic regression. Results: The magnitude of depression and loneliness among the elderly population was found to be 75.7% and 91%, respectively. Depression was significantly associated with elderly 60–69 years, females, with minimal education (illiterate), homemakers, number of family members >4, with no income, and dependent on others. Loneliness is significantly associated with the female gender, with illiterates, those who are not working and homemakers, below poverty line card holders, those with chronic diseases, and those dependent on others compared to their counterparts. There is a significant positive correlation between depression and loneliness scores among the elderly. Conclusion: The higher proportion of depression and loneliness among the elderly in our study emphasizes the necessary supportive measures. It needs to be addressed adequately through a coordinated primary care approach with community and social support.

This paper describes methods and findings from student cognitive labs, teacher cognitive labs, and test administration observations as evidence evaluated in a validity argument for a computer-based alternate assessment for students with significant cognitive disabilities. Validity of score interpretations and uses for alternate assessments based on alternate academic achievement standards (AA-AAAS) for students with the most significant cognitive disabilities require nontraditional sources of evidence about student-item interactions and the influences teachers have on those interactions. Our findings provide evidence that the assessment has been designed so students can show what they know and can do on multiple choice, technology-enhanced, and teacher administered item types and that teachers administer the assessments in a way that allows students to respond as intended. We conclude with a discussion on how the findings inform future test development, limitations, and implications for the use of these research methods for gathering validity evidence for an AA-AAAS.

In undergraduate life sciences education, open educational resources (OERs) increase accessibility and retention for students, reduce costs, and save instructors time and effort. Despite increasing awareness and utilization of these resources, OERs are not centrally located, and many undergraduate instructors describe challenges in locating relevant materials for use in their classes. To address this challenge, we have designed a resource collection (referred to as Open Resources for Biology Education, ORBE) with 89 unique resources that are primarily relevant to undergraduate life sciences education. To identify the resources in ORBE, we asked undergraduate life sciences instructors to list what OERs they use in their teaching and curated their responses. Here, we summarize the contents of the ORBE and describe how educators can use this resource as a tool to identify suitable materials to use in their classroom context. By highlighting the breadth of unique resources openly available for undergraduate biology education, we intend for the ORBE to increase instructors' awareness and use of OERs.

Many 4-year public institutions face significant pedagogical challenges due to the high ratio of students to teaching team members. To address the issue, we developed a workflow using the programming language R as a method to rapidly grade multiple-choice questions, adjust for errors, and grade answer-dependent style multiple-choice questions, thus shifting the teaching teams' time commitment back to student interaction. We provide an example of answer-dependent style multiple-choice questions and demonstrate how the output allows for discrete analysis of questions based on various categories such as Fundamental Statements or Bloom's Taxonomy Levels. Additionally, we show how student demographics can be easily integrated to yield a holistic perspective on student performance in a course. The workflow offers dynamic grading opportunities for multiple-choice questions and versatility through its adaptability to assessment analyses. This approach to multiple-choice questions allows instructors to pinpoint factors affecting student performance and respond to changes to foster a healthy learning environment.

To equip students with 21st-century skills, teachers must have both deep STEM content knowledge and the confidence to implement and teach appropriate STEM content. Many elementary teachers have inadequate STEM background knowledge, low confidence, and STEM self-efficacy for implementing STEM in the classroom; as a result, teachers' classroom practices are affected. The study examined how elementary teachers perceive their ability to implement STEM in the classroom. The STEM Efficacy Survey was sent to a randomized pool of 100 elementary educators, and 18 of them agreed to participate in the study. This instrument was designed to elicit responses related to the teachers' previous background in STEM, their beliefs about their ability to implement STEM, and their actual STEM implementation in the elementary classroom. The results revealed that participants were confident in their understanding of the engineering design process and problem-based learning. However, teachers were unwilling to apply the engineering design process in the classroom. From this research, the researchers concluded that higher levels of training in STEM education may influence how teachers perceive their ability to implement STEM in the classroom. Further research should focus on exploring how STEM training affects teachers' self-efficacy in STEM implementation.