Community-based management of severe acute malnutrition in India: new evidence from Bihar.

BACKGROUND: An estimated one-third of the world's children who are wasted live in India. In Bihar state, of children -2 SDs and MUAC >110 mm. These variables changed in July 2010 to admission on the basis of an MUAC <115 mm and discharge at an MUAC ≥120 mm. Uncomplicated SAM cases were treated as outpatients in the community by using a WHO-standard, ready-to-use, therapeutic lipid-based paste produced in India; complicated cases were treated as inpatients by using F75/F100 WHO-standard milk until they could complete treatment in the community. RESULTS: A total of 8274 children were admitted including 5149 girls (62.2%), 6613 children aged 6-23 mo (79.9%), and 87.3% children who belonged to Scheduled Caste, Scheduled Tribe, or Other Backward Caste families or households. Of 3873 children admitted under the old criteria, 41 children (1.1%) died, 2069 children (53.4%) were discharged as cured, and 1485 children (38.3%) defaulted. Of 4401 children admitted under the new criteria, 36 children (0.8%) died, 2526 children (57.4%) were discharged as cured, and 1591 children (36.2%) defaulted. For children discharged as cured, the mean (±SD) weight gain and length of stay were 4.7 ± 3.1 and 5.1 ± 3.7 g · kg(-1) · d(-1) and 8.7 ± 6.1 and 7.3 ± 5.6 wk under the old and new criteria, respectively (P < 0.01). After adjustment, significant risk factors for default were as follows: no community referral for admission, more severe wasting on admission, younger age, and a long commute for treatment. CONCLUSIONS: To our knowledge, this is the first conventional CMAM program in India and has achieved low mortality and high cure rates in nondefaulting children. The new admission criteria lower the threshold for severity with the result that more children are included who are at lower risk of death and have a smaller WHZ deficit to correct than do children identified by the old criteria. This study was registered as a retrospective observational analysis of routine program data at http://www.isrctn.com as ISRCTN13980582

Trends and Prevalence of Low Birth Weight in India: What Does data suggest?

Background: “Low birth weight” (LBW) is defined as birth weight < 2.5 kg (2500 grams). LBW infants remain at a relatively higher risk of mortality than those with normal birth weight. This is still a major public health problem in developing countries like India. This study examines the trend and prevalence of LBW in India and its data characteristics. Methods: National Family Health Survey (N.F.H.S.) data rounds were collected from 1992-2021. The study sample included women aged 15-49 years. The logistic regression model was fitted to assess the maternal determinants affecting the birth weight among newborns. Also, the heaping pattern of the data for each round of N.F.H.S. data was analyzed. Results: The trend and prevalence of low birth weight were reported 1884 (25.2%) in the first round of the National Family Health Survey, 1859 (22.7 %) in the second, 4146 (21.5%) in the third, 35476 (18.2%) in fourth, and 38167 (18.2%) in fifth, which remains constant in comparison to the previous round. Conclusion: The prevalence of LBW in India has declined over the past decades as reported in data like NFHS-I, II & III, but NFHS-IV and V are constant. Sociodemographic factors are shown as a risk factor for LBW. Data heaping is a key challenge to give the correct estimate of LBW and it is found in each round of the data set. Maternal health services are required during the gestation period to reduce the LBW and

Fine-tuning of a thermosalient phase transition by solid solutions

Thermosalient crystals are solids that exhibit motion at the macroscale as a consequence of a thermally induced phase transition. They represent an interesting scientific phenomenon and could be useful as actuators for the conversion of thermal energy into motion or mechanical work. The potential utilization of these miniature transducers in real-world devices requires a controllable phase transition (i.e. a predetermined temperature). While it is difficult to control these performances with a single-component molecular crystal, “tunable” properties could be accomplished by solid solutions. To verify this hypothesis, the thermosalient material [Zn(bpy)Br2] (bpy = 2,2′-bipyridine) was selected and its synthesis was performed in the presence of chloride ions. The resulting mixed crystals ([Zn(bpy)Br2xCl2(1−x)]) show that the product undergoes the expected thermosalient phase transition, and the temperature of the onset of the phase transition and the transition enthalpy depend on the Cl/Br ratio

Weight monitoring as an indicator of re-hospitalization in patients with heart failure

Background: Predicting the development of acute decompensated heart failure (ADHF) in chronic heart failure patients remains a challenge. Standard management of HF involves patient weight monitoring as it is generally accepted that body weight increase, reflecting fluid retention, may be of value in heralding imminent decompensation. Aim of the study was to evaluate body weight increment as an indicator of re-hospitalization in patients with heart failure.Methods: Fifty seven patients with principal diagnosis of heart failure, who got re-hospitalised due to decompensation as evidenced by deterioration of symptoms with increase in body weight, were analysed and compared with the parameters at last discharge with an attempt to look for the association between increase in weight and clinical deterioration.Results: Mean age of patients examined was 58.5 years. 54.4% of the patients were male. Mean weight of patients on re-hospitalization was 52.2 kg as compared to 48.8 kg at last discharge (p<0.05). 57.9% and 42.1% of patients presented in NYHA class IV & III respectively on re-hospitalization whereas all patients were discharged previously in NYHA class II status. Pearson chi-square test of association showed a significant deterioration of functional status (NYHA) in those having increase in weight ≥3kg as compared to <3 kg (p<0.05).Conclusions: A simple weight monitoring of heart failure patients can alert patients and their clinicians in early stages of decompensation preventing re-hospitalization

Experimental Evaluation of Strength Degradation Temperature for Carbon Epoxy Filament Wound Composite

Polymeric composites have been widely used in various structural and thermal aerospace applications. Polymeric composites having high strength and high modulus reinforcement are ideally suited for lot of critical aerospace applications as structure is designed with high specific strength and high specific modulus. In case of launch vehicles/ missile one such application is design and manufacturing of solid rocket motor casing with polymeric composites as it give high performance and reduces inert weight of propulsion system. The high specific strength and high specific modulus of composite materials makes it ideal choice for designing the composite rocket motor case (CRMC). These are manufactured with filament winding process. As per ASTM D 2290 test method, the apparent tensile strength can be evaluated by preparing ring specimens from filament wound shell which simulates the hoop winding and cylindrical geometry of composite motor case. During flight in trajectory, the temperature on external surface of rocket motor will rise due to kinetic heating as result of aerodynamic drag. The mechanical properties of FRP composites degrades beyond certain temperature, depending primarily upon resin system and its glass transition temperature (Tg). In present work, the method of ring fabrication using filament winding is used to prepare test samples to experimentally test and evaluate apparent tensile strength with temperature of Carbon Epoxy composite. The tensile test at ambient is also done on specimens made from carbon Epoxy laminate using filament winding technique and are compared with ring test results.. The Glass Transition temperature (Tg) for Carbon Epoxy is also determined with Dry Scanning Calorimetry (DSC) techniqu

Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group.

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness

A note on comonotonicity and positivity of the control components of decoupled quadratic FBSDE

In this small note we are concerned with the solution of Forward-Backward Stochastic Differential Equations (FBSDE) with drivers that grow quadratically in the control component (quadratic growth FBSDE or qgFBSDE). The main theorem is a comparison result that allows comparing componentwise the signs of the control processes of two different qgFBSDE. As a byproduct one obtains conditions that allow establishing the positivity of the control process.Comment: accepted for publicatio

Mushroom: an emerging source for next generation meat analogues

BackgroundIn recent years, plant-based and alternative protein sources have garnered attention. Since they may resemble the texture, flavour, and nutritional profile of typical meat products, mushroom-based meat substitutes have received attention. However, scaling up production, cost-effectiveness, and nutritional requirements similar to animal-based meat products remain hurdles. Thus, understanding these dynamics is crucial to the global development and adoption of next-generation mushroom-based meat substitutes.Scope and approachThis review examined and synthesised the current mushroom-based meat analogue research, concentrating on their physicochemical, nutritional, and qualitative properties. Also, evaluated worldwide market viability, consumer acceptance, and development and adoption difficulties and potential for next-generation mushroom-based meat substitutes.Key findings and conclusionsDue to their fleshiness, mushrooms can replace beef in sausages, nuggets, and patties. Rising vegetarianism and health concerns require meat substitutes. Due to their easy cultivation, excellent nutritional value, low fat and calorie content, and steady growth, mushrooms can meet this demand. However, there are still numerous chances and challenges to improve sensory features (texture, taste, and flavour), optimise processing, assess consumer satisfaction, and use different medicinal mushrooms as meat replacements. Thus, they are essential to the creation of nutritious, sustainable meat-based foods

Ensuring nutritional security in India through wheat biofortification: A review

Undernourishment of nutrients, also known as hidden hunger, affects over 2 billion populace globally. Even though stunting among children below five years of age has decreased in India in the last ten years, India is home to roughly thirty percent of the world's population of stunted pre-schoolers. A significant improvement has been witnessed in the targeted development and deployment of biofortified crops; approximately 20 million farm households from developing counties benefit from cultivating and consuming biofortified crops. There is ample scope for including biofortified varieties in the seed chain, ensuring nutritional security. Wheat is a dietary staple in India, typically consumed as wholemeal flour in the form of flatbreads such as chapatti and roti. Wheat contributes to nearly one fifth of global energy requirements and can also provide better amounts of iron (Fe) and zinc (Zn). As a result, biofortified wheat can serve as a medium for delivery of essential micronutrients such as Fe and Zn to end users. This review discusses wheat biofortification components such as Fe and Zn dynamics, its uptake and movement in plants, the genetics of their buildup, and the inclusion of biofortified wheat varieties in the seed multiplication chain concerning India