Architecture and Design of National Digital Identity Platforms

The importance of ‘National Digital Identity’ to provision public services to the citizens of a country and inclusive growth is fairly established. It is recognized as part of the UN sustainable digital goals (SDG) and various researchers have looked into the impact and relevance of such systems. Despite that not more than 5% of the countries globally are having comprehensive digital identity systems. Several such projects are facing major difficulties and implementation hurdles globally. There are cases where such projects have been abandoned. Countries such as India have implemented their national digital identity project as a platform with almost complete population coverage and most public services linked to it. This research analyses the architecture and design of such a digital identity platform through the lens of architectural leverage and generativity using the design science and General Morphological Analysis (GMA) approach. The learning’s are relevant for policy makers and technology designers to incorporate in their national digital identity initiatives

Development and Assessment of the Media Impact on Health Information Perception and Behavior Scale (Mihipb-S) Using Content Validity Index Method

With the omnipresence of media in the digital age, understanding its impact on individuals' health information perception and behaviors has become paramount. This study presents the meticulous development and rigorous validation of the Media Influence on Health Information Perception and Behavior Scale (MIHIPB-S) using the Content Validity Index (CVI) method. The scale development process comprised several critical phases, including item generation, expert panel formation, content validity assessment, and pilot testing. A panel of nine experts, encompassing diverse backgrounds such as psychology, public health, communication studies, and measurement development, rigorously examined each item's relevance to the construct of "Media Influence on Health Information Perception and Behavior." These experts assigned ratings on a 4-point Likert scale, ranging from "Not relevant" (1) to "Highly relevant" (4). To determine content validity, the study adhered to established recommendations for acceptable cut-off scores which were contingent upon the number of experts involved Lynn, Davis, Polit & Beck, and Polit et al.2006. Various validity indices, including the Item-Level Content Validity Index (I-CVI), Scale-Level Content Validity Index based on the Average Method (S-CVI/Ave), and Scale-Level Content Validity Index based on the Universal Agreement Method (S-CVI/UA), were meticulously calculated. The outcomes of the content validity assessment were resoundingly positive. All items within the MIHIPB-S attained remarkably high I-CVI scores, significantly exceeding the established acceptable threshold. Moreover, the S-CVI/Ave, calculated as the mean of the I-CVI scores for all items, unequivocally demonstrated robust content validity (Hamie et al. Ozair et al., Lau et al., and Marzuki et al.2018. Of particular significance, the S-CVI/UA, representing the proportion of items achieving the highest relevance rating by all experts, decisively met the prescribed cut-off score. These findings unequivocally affirm the MIHIPB-S as an exceptionally valid and comprehensive instrument for capturing the complex dynamics of media's influence on health information perception and behavior. The MIHIPB-S emerges as an invaluable and validated tool poised to make substantial contributions to research, practice, and policymaking within the domains of health communication, media literacy, and public health. Its versatility extends to assessing the efficacy of media-based health interventions, evaluating the impact of media campaigns on health decision-making, and informing targeted health communication strategies. Future endeavors should explore opportunities for cross-cultural validation, longitudinal assessments, and adaptations to account for emerging media modalities

Development and Validation of Physical Education Awareness Instrument (Pea-I)

Research Background: The importance of physical education in the development of young children has long been recognized. Despite this, there is a lack of a standardized instrument to accurately measure awareness of physical education among this demographic. The absence of such a tool hampers our understanding of children's perceptions and the impact of physical education on their overall well-being. Purpose: The primary objective of this study is to develop and validate the Physical Education Awareness Instrument (PEA-I) to assess young children's awareness of physical education. Through rigorous statistical techniques, including factor analysis and reliability assessment, the study seeks to establish the validity and reliability of the newly developed instrument. Materials and Methodology: The study involved 817 participants, randomly divided into two groups. The researchers utilized the expectation-maximization (EM) algorithm to handle potential missing values, although none were found in the collected responses. The first half of the sample (N = 317) underwent exploratory factor analysis (EFA) using IBM SPSS 26 for Windows. Latent root criteria and the Kaiser-Meyer-Olkin (KMO) index determined the optimal number of factors, indicating significant adequacy for principal component analysis (PCA). The EFA revealed a one-factor scale, with nine items demonstrating strong internal consistency (Cronbach's alpha ranged from 0.740 to 0.796). Statistical Procedure: Following the EFA, confirmatory factor analysis (CFA) was conducted on the second half of the sample using AMOS 23. All items in the CFA met the standard criterion, confirming the instrument's acceptable factor validity. The (PEA-I) exhibited good reliability and validity, establishing it as a robust tool to assess young children's awareness of physical education.  Results: The results solidify the PEA-I as a valid and reliable measure of physical education awareness among young children. Its factor loadings, internal consistency, and factor validity indicate its effectiveness in assessing individuals' perceived awareness of physical education accurately. Conclusion and practical implication: The (PEA-I) has practical implications, serving as a valuable tool for identifying individuals' awareness of physical education and evaluating the effectiveness of physical education programs. Its potential to aid policymakers, physical educators, and health professionals is significant, as it emphasizes the importance of physical education in overall well-being and advocates for its inclusion as a compulsory subject in schools. This study contributes substantially to the field, underscoring the significance of physical education in fostering healthier lifestyles and well-rounded individuals. The findings highlight the need for increased awareness and the positive impact of physical education on youth development, shaping the discourse on its promotion among policymakers, educators, and health professionals

A retrospective study of brochoscopic profile of patients in a tertiary care centre

Background: The purpose of this study was to find out the demographic profiles, indications, bronchoscopic findings and diagnosis of the patients who underwent bronchoscopic examination.Methods: A retrospective analysis of 200 consecutive fiber-optic bronchoscopies was performed at RMCH from June 2015 to June 2017 to find out the demographic and clinical profile of the patients who underwent this procedure. The instrument Olympus video bronchoscope was used for the procedure.Results: Among total of 200 patients, 131 (65.5%) were males and 69 (34.5%) patients were females. 150 (75%) patients were smokers and 50 (25%) patients were non- smokers. Cough was the most common presenting symptom in 180 (90%) of the patients followed by breathlessness 138 (69%), chest pain 114 (57%), hemoptysis 80 (40%), fever 66 (33%). The most common finding is endobronchial growth in 119 (59.5%) followed by nonspecific inflammation 40 (20%), inconclusive 21 (10.5%), normal 12 (6%), suspected growth 8 (4%).Out of 200 patient biopsy was done in 65 patients (32.5%) and most common histopathological diagnosis was malignancy 42 (64.61%), pulmonary tuberculosis 10 (15.38%), Infective pathology 9 (13.8%), inconclusive 4 (6.1%).Conclusions:Bronchoscopy is a safe and useful tool for making the diagnosis of a variety of pulmonary diseases. Endobronchial growth and malignancy were the commonest findings on bronchoscopy and histopathological examination respectively. Moreover, we would like to emphasize the importance of attempting biopsy from the abnormal segment of the lung even when bronchoscopy does not show frank mucosal growth.

Physiological Insights into Elite Sprint Paddlers: Unravelling Performance Dynamics and Training Implications

Study purpose. This study aimed to investigate the relationship between physiological reactivity and sprint paddling performance among elite athletes, focusing on cardiorespiratory responses, metabolic efficiency, and energy utilization patterns. Materials and methods. A group of N= 20 elite sprint paddlers from various regions in India was meticulously selected for this study. Detailed assessments of cardiorespiratory responses, metabolic efficiency, and energy utilization patterns were conducted using standardized protocols and cutting-edge measurement techniques. Individual differences among athletes were carefully documented. Results. The study revealed a remarkable homogeneity among the athletes, reflecting stringent training standards. However, intriguing individual differences emerged, particularly in cardiorespiratory reactivity. Athletes with swift neural responses and adept metabolic acidosis adaptation showcased enhanced overall performance, indicating the critical role of the nervous system and efficient respiratory mechanisms in optimizing paddlers’ capabilities. Analysis of CO2 emissions and lactate concentrations indicated a balanced energy utilization pattern and optimal anaerobic metabolism and respiratory responses. Balancing anaerobic alactate and lactate capacities emerged as pivotal. Conclusions. The findings underscore the need for targeted training programs that leverage individual differences, enhance neural adaptations, and metabolic acidosis tolerance, and optimize energy pathways. These transformative insights offer coaches, sports scientists, and athletes valuable tools to elevate performance outcomes. The study enriches our understanding of sprint paddling and serves as a paradigm for studying elite athletic performance, guiding the future of sports science and coaching. Future research avenues include exploring the long-term impact of tailored training interventions, investigating molecular mechanisms of cardiorespiratory reactivity, and studying psychological aspects of athletic performance. Comparative studies across diverse sports disciplines promise universal insights into elite athletic performance

Comparative study of uniform-MDT and WHO-MDT in pauci and multi bacillary leprosy patients over 18 months of observation

Background: To determine the efficacy of the current WHO-MDT and U-MDT regimen with regard to relapse rate and acceptability of the patients and to compare both regimen in pauci and multi bacillary cases.Methods: Total of 106 leprosy patients aged between 14-60 years attending department of Dermatology, Venerology and Leprosy at RIMS, Ranchi between May 2011 and October 2012 were included in the study and they were allocated alternatively into two groups, U-MDT and WHO-MDT. Patients were followed up for 12 to 18 months for periodic clinical, bacteriological and histopathological assessment.Results: In histopathological assessment of PB cases, after 6, 12 and 18 months, UPB group showed 91%, 100% and 100% improvement as compared to 77.5%, 86.5% and 95.2% in WPB group. Among multi bacillary cases, after 12 months 32% of UMB group of patients became smear negative whereas in WMB group 48% became smear negative. In histopathological assessment after 12 months, in UMB group, 94% patients showed good improvement whereas in WMB group only 77% patients showed good improvement. After 18 months, in UMB group, 50% patients deteriorated and showed poor improvement whereas almost 100% patients showed good improvements in WMB group.Conclusions: In conclusion, U-MDT was observed to be an effective and useful regimen to treat PB patients of leprosy, but in MB patients it was not found to be very effective regimen when compared to WHO-MDT of 12 months duration. Mere acceptability factor of the U-MDT regimen cannot be sufficient for its routine implementation in the general health service

Arsenic in Surface Waters: A Report from River Ganga and its Tributary Jamania at Bhagalpur, Bihar, India

An investigation has been carried out to examine the arsenic pollution status of River Ganga & its tributary Jamania during pre-monsoon period of  2017 at Bhagalpur, Bihar (India). Altogether 17 water samples from different sampling sites along with their geo co-ordinates have been investigated for the value of arsenic using FTK test as well as spectrophotometer method. Throughout the study, arsenic value ranged from 10.69 ppb to 55.92 ppb. Out of the 17 water samples, the values of arsenic in 13 samples were from 20ppb to 54.1ppb. The concentration levels of arsenic in all the 17 river water samples and 2 public water supply samples (source: river water) in the present study were found above from the permissible limit of WHO (2008) and BIS (2004-2005) standards for drinking which is 10 ppb (part per billion)

Assessment of psychological parameters, psychomotor speed, and quality of life in pre-hypertensive women

Background: Individual is considered as pre-hypertensive when the blood pressure is between 120 and 139/80–89 mmHg. There is an increase in the prevalence of pre-hypertension in Indian population. Hence, early diagnosis of pre-hypertension helps to prevent these diseases and increase the quantity and quality of life. Aims and Objectives: The present study was undertaken to observe the psychological parameters, psychomotor speed, and quality of life in pre-hypertensive women. Materials and Methods: Thirty cases of pre-hypertensive women between the age of 25 and 50 years and 30 age-matched non-pre-hypertensive women were included in the study. Depression, anxiety and stress, self-esteem, negative affectivity (NA) and social inhibition (SA), and quality of life were assessed using standard questionnaires. Visual and auditory reaction time (RT) was assessed using RT apparatus. Results: There was a significant (P<0.001) lower physical health score, psychological score, social relationships score, and environmental scores pre-hypertensive women when compared to healthy individuals. There was significantly (P<0.05) longer visual and auditory RT for the right and left responses in pre-hypertensive women when compared to healthy individuals. Significantly higher (P<0.05) levels of depression, anxiety, and stress and significantly lower self-esteem scores were observed in pre-hypertensive women when compared with healthy individuals. NA and SA were significantly higher (P<0.001) in pre-hypertensive women when compared with healthy individuals. Conclusion: Pre-hypertension has strong negative impact on psychological parameters, RT and quality of life. It is the need of time to increase awareness of pre-hypertension in general population. We recommend planning and implementation of special care programs for these individuals

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic