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This study used a series of individual-level datasets from National Family Health Surveys conducted in 1998-99, 2005-06 and 2015-16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998-99 and 2015-16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998-99 to 34.9% in 2015-16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998-99 to 33.1% in 2015-16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Resulthese measures to further reduce malnutrition among Indian children.South Asians, who are at a disproportionately greater risk of atherosclerotic CVD (ASCVD), represent a rapidly growing population in the USA. The relationship between dairy products, a major component of South Asian diets, and body composition - an established risk factor for ASCVD, is unclear. The aim of the present study was to examine associations between dairy intake and multiple measures of body composition (BMI, waist and hip circumference, waisthip ratio, abdominal lean mass, subcutaneous, visceral, and intermuscular fat areas) among South Asian adults in the USA. A baseline analysis was conducted using existing data from the Mediators of Atherosclerosis in South Asians Living in America cohort. In women, the highest (>1·9 servings/d) v. https://www.selleckchem.com/products/amlexanox.html lowest (3 servings of low-fat yogurt/week was associated with a 9·9 cm2 lower visceral fat area (95 % CI -19·07, -0·72, P less then 0·05) and 2·3 cm2 lower intermuscular fat area (95 % CI -3·76, -0·79, P less then 0·05) as compared with those with three servings/week. Milk and cheese were not associated with body composition measures. These analyses suggest that higher consumption of low-fat yogurt is associated with lower visceral and intermuscular fat in the whole sample, and women with higher dairy intake have lower waist circumference. Our study supports dietary incorporation of dairy products, and recognises the utility of multidimensional measures of central adiposity.
Discrepancies between the National Institute for Health and Care Excellence (NICE) schizophrenia guideline recommendations and current clinical practice in the UK have been reported.

We aim to assess whether it is cost-effective to improve adherence to the NICE schizophrenia guideline recommendations, compared with current practice.

A previously developed whole-disease model for schizophrenia, using the discrete event simulation method, was adapted to assess the cost and health impacts of adherence to the NICE recommendations. Three scenarios to improve adherence to the clinical guidelines were modelled universal provision of cognitive-behavioural therapy for patients at clinical high risk of psychosis, universal provision of family intervention for patients with first-episode psychosis and prompt provision of clozapine for patients with treatment-resistant schizophrenia. The primary outcomes were lifetime costs and quality-adjusted life-years gained.

The results suggest full adherence to the guidelinise potential cost savings.In a previous trial in Mali, we showed that traditional pearl millet couscous and thick porridge delayed gastric emptying (about 5 h half-emptying times) in a normal-weight population compared with non-traditional carbohydrate-based foods (pasta, potatoes, white rice; about 3 h half-emptying times), and in a gastric simulator we showed millet couscous had slower digestion than wheat couscous. In light of these findings, we tested the hypothesis in a normal-weight US population (n 14) that millet foods would reduce glycaemic response (continuous glucose monitor), improve appetitive sensations (visual analogue scale ratings), as well as reduce gastric emptying rate (13C-octanoic acid breath test). Five carbohydrate-based foods (millet couscous - commercial and self-made, millet thick porridge, wheat couscous, white rice) were fed in a crossover trial matched on available carbohydrate basis. Significantly lower overall glycaemic response was observed for all millet-based foods and wheat couscous compared with white rice (P ≤ 0·05). Millet couscous (self-made) had significantly higher glycaemic response than millet couscous (commercial) and wheat couscous (P less then 0·0001), but as there were no differences in peak glucose values an extended glycaemic response was indicated for self-made couscous. Millet couscous (self-made) had significantly lower hunger ratings and higher fullness ratings (P less then 0·05) than white rice, millet thick porridge and millet couscous (commercial). A normal gastric emptying rate ( less then 3 h half-emptying times) was observed for all foods, with no significant differences among them. In conclusion, some traditionally prepared pearl millet foods show the potential to reduce glycaemic response and promote satiety.
To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients.

This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups.

Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter.

All isolates belonged to the EAI2-Manila family and were grouped into four clusters based on their phenotypic drug resistance and mutation profiles.CONCLUSION The use of 24-loci set may be used as a more discriminatory MIRU-VNTR typing in settings where the East African-Indian lineage is predominant, like the Philippines.BACKGROUND The potential association between the lung function status at baseline and TB treatment outcome has not been evaluated previously. We aimed to investigate the impact of lung function status at the time of TB diagnosis on treatment outcome in patients with pulmonary TB (PTB).METHODS A retrospective cohort study on data from all consecutive patients with culture-confirmed PTB and available spirometry test results admitted during the year 2016 to the Regional anti-TB dispensary no.1 in Kharkiv, Ukraine.RESULTS A total of 278 patients with PTB were included into the study. The rate of negative treatment outcome (failure or death) was higher in patients with restrictive and mixed lung dysfunction than in those with normal spirometry results (25.6% vs. 6.8%, P = 0.0007; 37.5% vs. 6.8%, P = 0.003, respectively). In a logistic regression model, restrictive lung disease and mixed-type lung disease were associated with negative treatment outcome (OR 4.19, 95% CI 1.60-13.28, P = 0.007 and OR 5.46, 95% CI 1.28-24.44, P = 0.02, respectively).CONCLUSIONS Lung function at the time of diagnosis has an important impact on treatment outcomes in patients with PTB; the more severe the restriction in lung function the higher the likelihood of a negative treatment outcome.BACKGROUND One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS Data on autopsy-confirmed cases of dTB from over three decades (1988-2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.BACKGROUND Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB lung disease (PTLD) and assess associations between symptoms and impairment in two high TB incidence communities.METHODS This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1-5 years previously. https://www.selleckchem.com/products/wh-4-023.html Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors.RESULTS Of the 145 participants recruited (mean age 42 years, range 18-75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range 240-723). Respiratory symptoms were common chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4 n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers.CONCLUSION There was substantial burden of symptoms and physiological impairment in this "cured" population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.
Although no drugs are licensed for the treatment of personality disorder, pharmacological treatment in clinical practice remains common.

This study aimed to estimate the prevalence of psychotropic drug use and associations with psychological service use among people with personality disorder.

Using data from a large, anonymised mental healthcare database, we identified all adult patients with a diagnosis of personality disorder and ascertained psychotropic medication use between 1 August 2015 and 1 February 2016. Multivariable logistic regression models were constructed, adjusting for sociodemographic, clinical and service use factors, to examine the association between psychological services use and psychotropic medication prescribing.

Of 3366 identified patients, 2029 (60.3%) were prescribed some form of psychotropic medication. Patients using psychological services were significantly less likely to be prescribed psychotropic medication (adjusted odds ratio 0.48, 95% CI 0.39-0.59, P<0.001) such aences in demographic, clinical and service use characteristics. There is a need to develop clear prescribing guidelines and conduct research in clinical settings to examine medication effectiveness for this population.COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.

Participants made significantly more errors on the divided attention task during the interactive avatar VR condition, compared to passive VR, implicating an attention mechanism for how virtual reality reduces pain and helping understand how VR influences pain perception.Trial registration NCT04245475. Date of registration 29/01/2020.Genetic studies have examined body-shape measures adjusted for body mass index (BMI), while allometric indices are additionally adjusted for height. We performed the first genome-wide association study of A Body Shape Index (ABSI), Hip Index (HI) and the new Waist-to-Hip Index and compared these with traditional indices, using data from the UK Biobank Resource for 219,872 women and 186,825 men with white British ancestry and Bayesian linear mixed-models (BOLT-LMM). One to two thirds of the loci identified for allometric body-shape indices were novel. Most prominent was rs72959041 variant in RSPO3 gene, expressed in visceral adipose tissue and regulating adrenal cell renewal. Highly ranked were genes related to morphogenesis and organogenesis, previously additionally linked to cancer development and progression. Genetic associations were fewer in men compared to women. Prominent region-specific associations showed variants in loci VEGFA and HMGA1 for ABSI and KLF14 for HI in women, and C5orf67 and HOXC4/5 for ABSI and RSPO3, VEGFA and SLC30A10 for HI in men. Although more variants were associated with waist and hip circumference adjusted for BMI compared to ABSI and HI, associations with height had previously been reported for many of the additional variants, illustrating the importance of adjusting correctly for height.Modern solid-state gas sensors approaching ppb-level limit of detection open new perspectives for process control, environmental monitoring and exhaled breath analysis. Organic field-effect transistors (OFETs) are especially promising for gas sensing due to their outstanding sensitivities, low cost and small power consumption. https://www.selleckchem.com/products/NVP-ADW742.html However, they suffer of poor selectivity, requiring development of cross-selective arrays to distinguish analytes, and environmental instability, especially in humid air. Here we present the first fully integrated OFET-based electronic nose with the whole sensor array located on a single substrate. It features down to 30 ppb limit of detection provided by monolayer thick active layers and operates in air with up to 95% relative humidity. By means of principal component analysis, it is able to discriminate toxic air pollutants and monitor meat product freshness. The approach presented paves the way for developing affordable air sensing networks for the Internet of Things.Cerebral microhemorrhages (CMHs) are associated with cerebrovascular disease, cognitive impairment, and normal aging. One method to study CMHs is to analyze histological sections (5-40 μm) stained with Prussian blue. Currently, users manually and subjectively identify and quantify Prussian blue-stained regions of interest, which is prone to inter-individual variability and can lead to significant delays in data analysis. To improve this labor-intensive process, we developed and compared three digital pathology approaches to identify and quantify CMHs from Prussian blue-stained brain sections (1) ratiometric analysis of RGB pixel values, (2) phasor analysis of RGB images, and (3) deep learning using a mask region-based convolutional neural network. We applied these approaches to a preclinical mouse model of inflammation-induced CMHs. One-hundred CMHs were imaged using a 20 × objective and RGB color camera. To determine the ground truth, four users independently annotated Prussian blue-labeled CMHs. The deep learning and ratiometric approaches performed better than the phasor analysis approach compared to the ground truth. The deep learning approach had the most precision of the three methods. The ratiometric approach has the most versatility and maintained accuracy, albeit with less precision. Our data suggest that implementing these methods to analyze CMH images can drastically increase the processing speed while maintaining precision and accuracy.The importance of data quality to correctly determine prevalence estimates of child anthropometric failures has been a contentious issue among policymakers and researchers. Our research objective was to ascertain the impact of improved DHS data quality on the prevalence estimates of stunting, wasting, and underweight. The study also looks for the drivers of data quality. Using five data quality indicators based on age, sex, anthropometric measurements, and normality distribution, we arrive at two datasets of differential data quality and their estimates of anthropometric failures. For this purpose, we use the 2005-2006 and 2015-2016 NFHS data covering 311,182 observations from India. The prevalence estimates of stunting and underweight were virtually unchanged after the application of quality checks. The estimate of wasting had fallen 2 percentage points, indicating an overestimation of the true prevalence. However, this differential impact on the estimate of wasting was driven by the flagging procedure's sensitivity and was in accordance with empirical evidence from existing literature. We found DHS data quality to be of sufficiently high quality for the prevalence estimates of stunting and underweight, to not change significantly after further improving the data quality. The differential estimate of wasting is attributable to the sensitivity of the flagging procedure.Diagnosis of peritoneal metastasis in gastric cancer (GC) is essential for determining appropriate therapeutic strategies and avoiding non-essential laparotomy or gastrectomy. Recently, a variety of activatable fluorescence probes that can detect enzyme activities have been developed for cancer imaging. The aim of this study was to identify the key enzyme involved in peritoneal metastasis in GC. The enzymatic activity of gamma-glutamyl transpeptidase, dipeptidyl peptidase IV, and β-galactosidase (β-Gal) was assessed in lysates prepared from preserved human GC (n = 89) and normal peritoneal (NP; n = 20) samples. β-Gal activity was significantly higher in the human GC samples than in NP samples, whereas no differences were observed in the activities of the other enzymes. Therefore, we used SPiDER-βGal, a fluorescent probe that can be activated by β-Gal, for imaging GC cell lines, peritoneal metastasis in a mouse model, and fresh human resected GC samples (n = 13). All cell lines showed fluorescence after applying SPiDER-βGal, and metastatic nodules in the mice gradually developed high fluorescence that could be visualized with SPiDER-βGal.

In that sense, this paper contributes to a better understanding of the historical and contemporary dynamics in European LCCs choice of airports and, in particular, the long-term effects that this disruptive business model have had for airports. This is increasingly important in the context of a potential recovery path from the effects of the response to the Covid-19 pandemic. This paper also attempts to settle academic discussions that attach LCC development to secondary/regional airports disregarding the wide range of strategies used by airlines and airports.
The devastating spread of the novel coronavirus, named COVID-19, starting its journey from Wuhan Province of China on January 21st, 2020, has now threatened lives of almost all the countries of the world in different magnitudes. Mostly the developed countries have been hit hard, besides the emerging countries like China, India and Brazil. The scientists and the policy makers are in dark with respect to its spread and claiming lives in coming days.

The present study aims to forecast the number of incidences in severely affected seven countries, USA, UK, Italy, Spain, France, China and India, for the period July 12-Septmeber 11, 2020 and compares the forecasted values with the actual values to judge its depth of severity and growth.

The study uses Box-Jenkins method of forecasting in an Autoregressive Integrated Moving Average (ARIMA) structure on the basis of the daily data published by World Health Organization from January 21st to July 11, 2020.

It is observed that USA and India are the two countriesforecasted period will be diminishing. The mean difference test results between the forecasted and actual values in level and growth forms show that in the former case, USA, India, UK will face increasing forecast than the actual number but in the latter case, all of the countries will face significantly decreasing growth rates in the forecasted values compared to their actual growth values.The development of novel digital auscultation techniques has become highly significant in the context of the outburst of the pandemic COVID 19. The present work reports the spectral, nonlinear time series, fractal, and complexity analysis of vesicular (VB) and bronchial (BB) breath signals. The analysis is carried out with 37 breath sound signals. https://www.selleckchem.com/products/etc-159.html The spectral analysis brings out the signatures of VB and BB through the power spectral density plot and wavelet scalogram. The dynamics of airflow through the respiratory tract during VB and BB are investigated using the nonlinear time series and complexity analyses in terms of the phase portrait, fractal dimension, Hurst exponent, and sample entropy. The higher degree of chaoticity in BB relative to VB is unwrapped through the maximal Lyapunov exponent. The principal component analysis helps in classifying VB and BB sound signals through the feature extraction from the power spectral density data. The method proposed in the present work is simple, cost-effective, and sensitive, with a far-reaching potential of addressing and diagnosing the current issue of COVID 19 through lung auscultation.We analytically study the SEIR (Susceptible Exposed Infectious Removed) epidemic model. The aim is to provide simple analytical expressions for the peak and asymptotic values and their characteristic times of the populations affected by the COVID-19 pandemic.We describe in this paper a hybrid intelligent approach for forecasting COVID-19 time series combining fractal theory and fuzzy logic. The mathematical concept of the fractal dimension is used to measure the complexity of the dynamics in the time series of the countries in the world. Fuzzy Logic is used to represent the uncertainty in the process of making a forecast. The hybrid approach consists on a fuzzy model formed by a set of fuzzy rules that use as input values the linear and nonlinear fractal dimensions of the time series and as outputs the forecast for the countries based on the COVID-19 time series of confirmed cases and deaths. The main contribution is the proposed hybrid approach combining the fractal dimension and fuzzy logic for enabling an efficient and accurate forecasting of COVID-19 time series. Publicly available data sets of 10 countries in the world have been used to build the fuzzy model with time series in a fixed period. After that, other periods of time were used to verify the effectiveness of the proposed approach for the forecasted values of the 10 countries. Forecasting windows of 10 and 30 days ahead were used to test the proposed approach. Forecasting average accuracy is 98%, which can be considered good considering the complexity of the COVID problem. The proposed approach can help people in charge of decision making to fight the pandemic can use the information of a short window to decide immediate actions and also the longer window (like 30 days) can be beneficial in long term decisions.The generalized logistic equation is used to interpret the COVID-19 epidemic data in several countries Austria, Switzerland, the Netherlands, Italy, Turkey and South Korea. The model coefficients are calculated the growth rate and the expected number of infected people, as well as the exponent indexes in the generalized logistic equation. It is shown that the dependence of the number of the infected people on time is well described on average by the logistic curve (within the framework of a simple or generalized logistic equation) with a determination coefficient exceeding 0.8. At the same time, the dependence of the number of the infected people per day on time has a very uneven character and can be described very roughly by the logistic curve. To describe it, it is necessary to take into account the dependence of the model coefficients on time or on the total number of cases. Variations, for example, of the growth rate can reach 60%. The variability spectra of the coefficients have characteristic peaks at periods of several days, which corresponds to the observed serial intervals. The use of the stochastic logistic equation is proposed to estimate the number of probable peaks in the coronavirus incidence.