Participatory Management Process in Natural Resource Management (NRM) by Women Groups

Conserving the natural resources results in improved agricultural productivity which is a key driver for poverty reduction in rural areas. To empower the women and to enhance their socio-economic status for better livelihoods, Self-Help Groups (SHG) were formed by both the Government Organizations (GO) and Non-Government Organizations (NGO). They facilitated the participation of women through various means in Natural Resource Management (NRM) activities. To find out the distribution of the women groups in different stages of NRM activities and to analyze the influence of profile, supportive, structural and functional characteristics on participatory management in NRM activities, an ex-post facto study was conducted in Telangana, Coastal Andhra and Rayalaseema regions among 240 SHGs. The study revealed that majority of the women respondents had medium level of ‘total participatory management’ followed by high level and low level

Maternal hemodynamics in normal pregnancy: reference ranges and role of maternal characteristics

Objectives The main aim of this study was to construct reference ranges of maternal central hemodynamic parameters during pregnancy. The second aim was to determine the maternal and pregnancy characteristics that influence these hemodynamic parameters. Methods This was a prospective cohort study of low‐risk pregnant women attending for routine antenatal care at St George's Hospital, London, UK. Exclusion criteria included any medical disorder present at the time of study recruitment, or development of hypertension or intrauterine fetal growth restriction following study recruitment. Stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) were obtained using non‐invasive cardiac output monitoring (USCOM‐1A®). USCOM‐1A utilizes a non‐imaging probe in the suprasternal notch to obtain velocity‐time integrals of transaortic blood flow at the left ventricular outflow tract. Once the distribution of the data with respect to gestational age had been determined, maternal characteristics were added to the model to test whether they provided a significant improvement in the prediction of the median value. Results The study included 627 women with a singleton pregnancy. The estimated median CO was constant for a maternal age above 32 years, but was around 0.5 L/min higher for women aged ≤ 25 years (P < 0.001). Maternal weight (P < 0.001) and height (P < 0.001) significantly affected CO values and there was a significant interaction (P = 0.002) between them. In women with a height of less than 1.60 m, there was no association between median CO and weight; however, in those with a height exceeding 1.60 m, an increase in weight was associated with an increase in CO. SV was primarily associated with height (P < 0.001), although some positive association with weight (P < 0.001) could also be observed within the normal body‐mass‐index range. Greater height (P < 0.001) was associated with lower median values of SVR, with an estimated difference of around 120 dynes × s/cm5 between 1.60 m and 1.80 m. Advancing maternal age was associated with higher median SVR, with an estimated difference of around 50 dynes × s/cm5 between 25 and 35 years. Smokers had a lower SVR by 73.5 (95% CI, 8.6–138.4) dynes × s/cm5. Conclusion Maternal hemodynamics are influenced significantly by maternal age, height and weight. We provide USCOM‐1A‐specific reference ranges and a calculator for SV, CO and SVR in uncomplicated pregnancies that correct for maternal age, height and weight. This should enable clinical application and comparison in both uncomplicated and pathological pregnancies

Impaired Maternal Hemodynamics in Morbidly Obese Women: A Case-control Study.

AIM: Maternal obesity is associated with significant pregnancy complications and is a risk factor for the development of hypertensive disorders of pregnancy as well as other adverse outcomes. There are few data regarding the hemodynamic aberrations observed in maternal obesity. The aim of this study was to investigate maternal hemodynamics in morbidly obese pregnant women. METHODS: This was a prospective, case-control study of morbidly obese women (BMI >40 kg/m(2) ) and controls (BMI 20-29.9 kg/m(2) ) at a ratio of one-to-ten. The control population was matched for maternal age and gestational age. BMI was calculated based on maternal height and weight at the time of recruitment to the study, which occurred on the same day as the hemodynamic assessment. Pregnant women in the second or third trimester of pregnancy were included. Women who were found to be hypertensive at any time were excluded from the study. USCOM-1A(®) was used to assess hemodynamic parameters (heart rate, stroke volume, cardiac output and systemic vascular resistance). The parameters were corrected for body surface area (BSA) to provide the stroke volume index (SVI), cardiac index (CI) and systemic vascular resistance index (SVRI). Mann Whitney-U test was used to compare the medians of the hemodynamic variables between the two groups. RESULTS: A total of 30 obese women and 327 controls were recruited. There was no difference in maternal (p = 0.506) or gestational (p = 0.693) age at recruitment between the groups. Mean arterial pressure was higher both at pregnancy booking (90 vs 80 mmHg, p < 0.001) and study recruitment (91 vs 85 mmHg, p < 0.001) in the obese group. Heart rate was higher in the obese group (p = 0.003), however there was no difference in stroke volume (p = 0.271), cardiac output (p = 0.238) or systemic vascular resistance (p = 0.635). Following correction of these parameters for BSA, the SVI (34 vs 45 ml/m(2) , p < 0.001) and CI (2.96 vs 3.64 L/min/m(2) , p < 0.001) were significantly reduced in the obese group, whilst the SVRI was significantly higher (2354 vs 1840 dynes-sec-cm(5) /m(2) , p < 0.001). CONCLUSION: The findings of our study suggest that cardiac function is significantly altered in morbidly obese pregnant women. In order to make appropriate comparisons between individuals, it is imperative that hemodynamic parameters are indexed for BSA - as indeed they are in pediatric cardiology. The novel finding of a reduced CI in morbidly obese pregnant women may explain the predisposition to preeclampsia and other adverse outcomes in this population and warrants further investigation

Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal

<p><b>Copyright information:</b></p><p>Taken from "Association of oestrogen receptor beta 2 (ERβ2/ERβcx) with outcome of adjuvant endocrine treatment for primary breast cancer – a retrospective study"</p><p>http://www.biomedcentral.com/1471-2407/7/131</p><p>BMC Cancer 2007;7():131-131.</p><p>Published online 18 Jul 2007</p><p>PMCID:PMC1950511.</p><p></p>ses) and dichotomised levels of ERβ2 mRNA in the ERα + tamoxifen-treated cohort and (B, 4 events in 29 ERβ2 high cases and 12 events in 29 ERβ2 low cases). Unbroken green lines represent cases with high levels of ERβ2, dotted blue lines represent cases with low levels. In all cases crosses represent censored data and P values are given for Log Rank tests

Maternal Hemodynamics in Normal Pregnancies: Reference ranges and the Role of Maternal Characteristics

Objectives The main aim of this study was to construct reference ranges of the maternal central hemodynamic parameters during pregnancy. The second aim was to determine the maternal and pregnancy characteristics, which influence these hemodynamic parameters. Methods This was a prospective cohort study of low-risk pregnant women attending for routine antenatal care at St George's Hospital, London. The exclusion criteria included any medical disorder present at the time of study recruitment, or development of hypertension or intrauterine fetal growth restriction following study recruitment. Stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) were obtained using non-invasive cardiac output monitoring (USCOM-1A®). USCOM-1A® utilises a non-imaging probe in the suprasternal notch to obtain velocity-time integrals of transaortic blood flow at the left ventricular outflow tract. Once the distribution of the data had been determined with respect to the gestational age (GA), maternal characteristics were added to the model to test whether they provided a significant improvement in the prediction of the median value. Results The analysis included 627 singleton pregnancies. The estimated median CO was constant for a maternal age above 32 years, but was around 0.5 L/min higher for women aged 25 or younger (p < 0.001). Maternal weight (p < 0.001) and height (p < 0.001) affected CO and there was a significant interaction (p = 0.002). In women with a height less than 1.60 m, there was no association between median CO and weight. In those with a height exceeding 1.60 m, an increase in weight was associated with an increase in CO. SV was primarily associated with height (p < 0.001), although some positive association with weight (p < 0.001) can also be observed within the normal body mass index range. Greater height (p < 0.001) was associated with lower median values of SVR with an estimated difference of around 120 dynes · sec · cm5 between 1.60 m and 1.80 m. Advancing maternal age was associated with higher median SVR with an estimated difference of around 50 dynes · sec · cm5 between 25 and 35 years. Smokers had a lower SVR of 73.5 (95% CI, 8.6 – 138.4) dynes · sec · cm5. Conclusion Maternal hemodynamics are significantly influenced by maternal age, height and weight. We provide USCOM-1A®-specific reference ranges and calculator for SV, CO and SVR in uncomplicated pregnancies that correct for maternal age, height and weight. This will enable clinical application and comparison in both uncomplicated and pathological pregnancies

ProbCD: enrichment analysis accounting for categorization uncertainty

As in many other areas of science, systems biology makes extensive use of statistical association and significance estimates in contingency tables, a type of categorical data analysis known in this field as enrichment (also over-representation or enhancement) analysis. In spite of efforts to create probabilistic annotations, especially in the Gene Ontology context, or to deal with uncertainty in high throughput-based datasets, current enrichment methods largely ignore this probabilistic information since they are mainly based on variants of the Fisher Exact Test. We developed an open-source R package to deal with probabilistic categorical data analysis, ProbCD, that does not require a static contingency table. The contingency table for&#xd;&#xa;the enrichment problem is built using the expectation of a Bernoulli Scheme stochastic process given the categorization probabilities. An on-line interface was created to allow usage by non-programmers and is available at: http://xerad.systemsbiology.net/ProbCD/. We present an analysis framework and software tools to address the issue of uncertainty in categorical data analysis. In particular, concerning the enrichment analysis, ProbCD can accommodate: (i) the stochastic nature of the high-throughput experimental techniques and (ii) probabilistic gene annotation

Painful swollen leg – think beyond deep vein thrombosis or Baker's cyst

<p>Abstract</p> <p>Background</p> <p>The diagnosis of deep vein thrombosis of leg is very common in clinical practice. Not infrequently a range of pathologies are diagnosed after excluding a thrombosis, often after a period of anticoagulation.</p> <p>Case presentation</p> <p>This is a report of three patients who presented with a painful swollen leg and were initially treated as a deep vein thrombosis or a baker's cyst, but later diagnosed as a pleomorphic sarcoma, a malignant giant cell tumor of the muscle and a myxoid liposarcoma. A brief review of such similar reports and the relevant literature is presented.</p> <p>Conclusion</p> <p>A painful swollen leg is a common clinical scenario and though rare, tumors must be thought of without any delay, in a duplex negative, low risk deep vein thrombosis situation.</p

Support vector machine versus logistic regression modeling for prediction of hospital mortality in critically ill patients with haematological malignancies

Background: Several models for mortality prediction have been constructed for critically ill patients with haematological malignancies in recent years. These models have proven to be equally or more accurate in predicting hospital mortality in patients with haematological malignancies than ICU severity of illness scores such as the APACHE II or SAPS II [1]. The objective of this study is to compare the accuracy of predicting hospital mortality in patients with haematological malignancies admitted to the ICU between models based on multiple logistic regression (MLR) and support vector machine (SVM) based models. Methods: 352 patients with haematological malignancies admitted to the ICU between 1997 and 2006 for a life-threatening complication were included. 252 patient records were used for training of the models and 100 were used for validation. In a first model 12 input variables were included for comparison between MLR and SVM. In a second more complex model 17 input variables were used. MLR and SVM analysis were performed independently from each other. Discrimination was evaluated using the area under the receiver operating characteristic (ROC) curves (+/- SE). Results: The area under ROC curve for the MLR and SVM in the validation data set were 0.768 (+/- 0.04) vs. 0.802 (+/- 0.04) in the first model (p = 0.19) and 0.781 (+/- 0.05) vs. 0.808 (+/- 0.04) in the second more complex model (p = 0.44). SVM needed only 4 variables to make its prediction in both models, whereas MLR needed 7 and 8 variables in the first and second model respectively. Conclusion: The discriminative power of both the MLR and SVM models was good. No statistically significant differences were found in discriminative power between MLR and SVM for prediction of hospital mortality in critically ill patients with haematological malignancies

Association of oestrogen receptor beta 2 (ERβ2/ERβcx) with outcome of adjuvant endocrine treatment for primary breast cancer – a retrospective study

<p>Abstract</p> <p>Background</p> <p>Oestrogen receptor beta (ERβ) modulates ERα activity; wild type ERβ (ERβ1) and its splice variants may therefore impact on hormone responsiveness of breast cancer. ERβ2/ERβcx acts as a dominant negative inhibitor of ERα and expression of ERβ2 mRNA has been proposed as a candidate marker for outcome in primary breast cancer following adjuvant endocrine therapy. We therefore now assess ERβ2 protein by immunostaining and mRNA by quantitative RT-PCR in relation to treatment outcome.</p> <p>Methods</p> <p>ERβ2-specific immunostaining was quantified in 141 primary breast cancer cases receiving adjuvant endocrine therapy, but no neoadjuvant therapy or adjuvant chemotherapy. The expression of mRNA for ERβ2/ERβcx was measured in 100 cases by quantitative RT-PCR. Statistical analysis of breast cancer relapse and breast cancer survival was performed using Kaplan Meier log-rank tests and Cox's univariate and multivariate survival analysis.</p> <p>Results</p> <p>High ERβ2 immunostaining (Allred score >5) and high ERβ2 mRNA levels were independently associated with significantly better outcome across the whole cohort, including both ERα positive and negative cases (Log-Rank P < 0.05). However, only ERβ2 mRNA levels were significantly associated with better outcome in the ERα + subgroup (Log-Rank P = 0.01) and this was independent of grade, size, nodal status and progesterone receptor status (Cox hazard ratio 0.31 P = 0.02 for relapse; 0.17 P = 0.01 for survival). High ERβ2 mRNA was also associated with better outcome in node negative cases (Log Rank P < 0.001).</p> <p>ERβ2 protein levels were greater in ERα positive cases (T-test P = 0.00001), possibly explaining the association with better outcome. Levels of ERβ2 protein did not correlate ERβ2 mRNA levels, but 34% of cases had both high mRNA and protein and had a significantly better outcome (Log-Rank relapse P < 0.005).</p> <p>Conclusion</p> <p>High ERβ2 protein levels were associated with ERα expression. Although most cases with high ERβ2 mRNA had strong ERβ2 immunostaining, mRNA levels but not protein levels were independently predictive of outcome in tamoxifen-treated ERα + tumours. Post-transcriptional control needs to be considered when assessing the biological or clinical importance of ERβ proteins.</p

Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial

Background Severe early-onset fetal growth restriction can lead to a range of adverse outcomes including fetal or neonatal death, neurodisability, and lifelong risks to the health of the affected child. Sildenafil, a phosphodiesterase type 5 inhibitor, potentiates the actions of nitric oxide, which leads to vasodilatation of the uterine vessels and might improve fetal growth in utero. Methods We did this superiority, placebo-controlled randomised trial in 19 fetal medicine units in the UK. We used random computer allocation (1:1) to assign women with singleton pregnancies between 22 weeks and 0 days' gestation and 29 weeks and 6 days' gestation and severe early-onset fetal growth restriction to receive either sildenafil 25 mg three times daily or placebo until 32 weeks and 0 days' gestation or delivery. We stratified women by site and by their gestational age at randomisation (before week 26 and 0 days or at week 26 and 0 days or later). We defined fetal growth restriction as a combination of estimated fetal weight or abdominal circumference below tenth percentile and absent or reversed end-diastolic blood flow in the umbilical artery on Doppler velocimetry. The primary outcome was the time from randomisation to delivery, measured in days. This study is registered with BioMed Central, number ISRCTN 39133303. Findings Between Nov 21, 2014, and July 6, 2016, we recruited 135 women and randomly assigned 70 women to sildenafil and 65 women to placebo. We found no difference in the median randomisation to delivery interval between women assigned to sildenafil (17 days [IQR 7–24]) and women assigned to placebo (18 days [8–28]; p=0·23). Livebirths (relative risk [RR] 1·06, 95% CI 0·84 to 1·33; p=0·62), fetal deaths (0·89, 0·54 to 1·45; p=0·64), neonatal deaths (1·33, 0·54 to 3·28; p=0·53), and birthweight (−14 g,–100 to 126; p=0·81) did not differ between groups. No differences were found for any other secondary outcomes. Eight serious adverse events were reported during the course of the study (six in the placebo group and two in the sildenafil group); none of these were attributed to sildenafil. Interpretation Sildenafil did not prolong pregnancy or improve pregnancy outcomes in severe early-onset fetal growth restriction and therefore it should not be prescribed for this indication outside of research studies with explicit participants' consent. Funding National Institute for Health Research and Medical Research Council