Rainfed agriculture: unlocking the potential

Rainfed farming / Soil degradation / Crop production / Climate change / Irrigation methods / Water harvesting / Yield gap / Models / Supplemental irrigation / Water productivity / Watershed management / India

Healthcare Utilization for Behavioral Health Disorders: Policy Implications on Nationwide Readmissions, and Outcomes in the States of Nebraska and New York

The main goal of this dissertation was to estimate national-level inpatient readmissions and state-level hospital-based emergency department (ED) visits with behavioral health (BH) conditions in the states of Nebraska and New York. The dissertation aims to assess the impact of the policy mandates under the Patient Protection and Affordable Care Act on these state and national estimates. The Nationwide Readmissions Database and the State Emergency Department databases maintained by the Healthcare Cost and Utilization Project were used for this dissertation. US Adult population with high-risk of readmissions in the inpatient departments for alcohol-related disorders (ARD) and of visiting ED for BH conditions were identified. Prediction of economic burden due to 30-day readmissions, specifically for recurrences of ARD, patient and hospital-level rates, costs, and predictors of 30-day readmissions were derived at the national level. Region-level data on ED facilities and BH workforce in Nebraska were obtained from the Health Professionals Tracking Services. In addition, the location of substance abuse treatment centers and ED facilities in New York were procured from the National Survey of Substance Abuse Treatment Services and the National Emergency Department Inventory, respectively. To identify BH conditions, International Classification of Diseases, Ninth Revision, Clinical Modification codes were used. Estimates of total charges for ED visits in Nebraska and New York were performed along with an assessment of the availability of substance abuse treatment centers, BH workforce, and EDs. The dissertation underlines the need for integrated behavioral health services at a primary level and development of preventative health programs tailored specifically for high-risk populations

Evaluation of surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamber

Introduction: Findings from specular microscope studies have demonstrated increased endothelial cell loss associated with the use of air for lens implantation. The objective of this study was to evaluate the surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamberDesign: Retrospective record analysisSubjects: Record cards of patients operated for cataract at Sakubva Eye Unit, Mutare, Zimbabwe in the period January – December 2002 Main outcome measures: Operative complications, post operative keratitis, presenting visual acuity at discharge, two and six weeks postoperatively.Results: Record cards of 315 patients were analysed, 207 (65.7%) had lens implantation under air, 108 (34.3%) had implantation under viscoelastic. Presenting visual acuity at discharge, two and six weeks postoperatively was better or equal to 6/18 in 36.7%, 34.4% and 52% of patients implanted under air compared to 40.7%, 35.6% and 38.3% of those implanted under viscoelastic. Post operative keratitis was observed in 14% of patients implanted under air and 12% of those implanted under viscoelastic. Vitreous loss was experienced by 1.9% and 5.8% of patients implanted under air and viscoelastic respectively.Conclusion: Despite reports of increased endothelial cell loss associated with use of air for lens implantation, this study finds no difference in surgical outcome between patients implanted posterior chamber lens under air or viscoelastic

Uterine inversion - an obstetrician’s nightmare: a series of 3 cases of uterine inversion and a review of management options

Acute puerperal uterine inversion is an extremely rare but potentially life-threatening complication in which the uterine fundus collapses within the endometrial cavity and beyond. Although the causes of uterine inversion are unclear, several predisposing factors have been described. Maternal mortality is extremely high unless the condition is recognized and corrected. We present here a series of three cases of uterine inversion managed in our hospital over a period of 3 years. Our first case, Mrs XYZ referred to our hospital after vaginal delivery followed by postpartum collapse. The patient was in hypovolemic shock with 2nd degree uterine inversion. Second case, Mrs ABC referred to our hospital after vaginal delivery and mass coming out of the vagina. The patient had postpartum haemorrhage with 2nd degree uterine inversion. Our third case, Mrs DEF, c/o full term vaginal delivery at our hospital with 2nd degree uterine inversion with postpartum haemorrhage. In all three cases, the patients were explored in the OT under general anaesthesia and uterine reposition was done vaginally. Two of the patients required mechanical ventilation post operatively and all the patients required blood and blood product transfusion. The clinical management, treatment options and surgical nuances of management of uterine inversion are discussed

Mucinous cystadenoma of ovary: are mammoths really extinct?

The most common ovarian tumours are epithelial tumours. 80% of all tumours are benign, 10% borderline and 10% are malignant. Mucinous tumours represent 8-10% of the epithelial tumours; they may reach enormous size filling the entire abdominal cavity. We report here a case of a huge benign mucinous cystadenoma in a 57-year-old female. Ultrasound and MRI scan showed a large left ovarian cyst. CA-125 was 132 IU/ml. She underwent total abdominal hysterectomy and bilateral salpingo-opherectomy with appendicectomy and infracolic omentectomy. Her post-operative course was unremarkable

Suicide Among South Asians in the United States: A Growing Public Health Problem

This research study quantifies and describes suicide among South Asian Americans (SAAs), an emerging population that are underrepresented group in suicide research. The purpose of this study was to examine key characteristics of suicide deaths among SAAs. Data were employed from DuPage County, IL, a county with a large SAA population. Following federal recommendations for disaggregating Asian American data at a granular level, four SAA researchers used name recognition to identify all SAA cases classified as suicide in the DuPage County coroner’s database from 2001 to 2017 (N = 38). Coroner’s reports were analyzed for contextual details and correlating factors specific to each suicide. Overall, 76.3% of victims were male and 45.0% were married. An analysis of the coroner reports established that 71.1% of decedents showed behavioral disorders that were predisposing risk factors for suicide including mental health diagnoses (57.9%), and a reported prior suicide attempt (21.1%). Among these decedents only 34.2% had received any prior psychiatric care. Significant errors in racial classification of SAAs, lead to a gross undercount of SAA deaths by suicide with 55% of South Asian suicides assigned to a different race or ethnic group. Future studies must increase the scope of this research to other geographic locations with high concentrations of SAAs and examine the risk factors for suicide among SAAs, one of the fastest growing ethnic populations in the U.S

Effect of Sm3+ as co-dopant in CaSO4:Dy,P TLD phosphor

CaSO4: Dy,P  and CaSO4:Dy,P,Sm  thermoluminescence (TL) phosphors have been prepared by acid method and their TL glow curves and  photoluminescence (PL)  excitation and emission spectra are recorded. PL emission bands at 565, 599 and 613 nm were observed for CaSO4: Dy,P,Sm under the excitation wavelength 402 nm. Dosimetric peak is observed around 2460C at high temperature.  Co-doping of Sm3+ in CaSO4:Dy,P enhances its TL intensity by a factor of 1.11

Tidal Turbine Generators

Recently, tidal stream turbines have become a preferable mode of harvesting tidal energy. The main issue for low utilization of tidal energy is the high levelized cost of energy (LCoE) from tidal stream turbines. A major reason for this is the high operation and maintenance costs for submerged installations. A possible way of minimizing the LCoE and improving the availability is to use a flooded (or a wetgap) generator rather than a conventional airgap generator. Inside flooded generators, the gap between the stator and rotor is filled with the seawater. This architecture has the potential to improve cooling and reduce reliance on ancillary systems (e.g., bilge system), thereby improving reliability. The chapter begins with a brief description of the generator systems used in current tidal stream turbines. The focus of the chapter is, however, to give a basic insight into the design aspects of the flooded generators, and compares it with the currently used sealed airgap generators in tidal turbine systems

Evaluation of efficacy of injection ferric carboxymaltose in pregnant women

Background: Iron deficiency anaemia (IDA) continues to be a very common problem in developing countries leading to a spectrum of adverse events in pregnant women. The objective of this study was to determine the efficacy, side effects and tolerance of ferric carboxymaltose as compared to available iron preparations for the prophylaxis and treatment of mild to moderate iron deficiency anaemia during pregnancy.Methods: One-year clinical study (from June 2017 to May 2018). A total 100 patients were enrolled after matching inclusion and exclusion criteria. The efficacy assessment was performed during 4, 8, and 12 weeks of starting therapy. If the patient is not responding to therapy in either arm as documented by no rise or fall in haemoglobin levels patients may be removed from study for other therapy. Treatment duration up to 12 weeks. Safety and efficacy follow-up visit at 4, 8 and 12 weeks. Institutional ethics committee permission was taken.Results: On intra-group comparisons there was significant increase in haemoglobin levels at 8 and 12 weeks in oral iron group as compared to day 1 haemoglobin levels while there was significant increase in haemoglobin levels at 4, 8 and 12 weeks in IV iron group as compared to day 1 haemoglobin levels. On intergroup comparisons between oral and IV iron group, there was significant increase in haemoglobin levels at 4, 8 and 12 weeks in IV iron group as compared oral iron group haemoglobin levels.Conclusions: Intravenous iron therapy with ferric carboxymaltose causes significant improvement in haemoglobin more quickly and more effective in correcting iron deficiency anaemia in pregnancy compared to oral treatment in terms of increase in haemoglobin levels at 4, 8 and 12 weeks. Intravenous ferric carboxymaltose is safe and effective option for pregnant women with iron deficiency anaemia

A Polycomb Group Protein Is Retained at Specific Sites on Chromatin in Mitosis

Epigenetic regulation of gene expression, including by Polycomb Group (PcG) proteins, may depend on heritable chromatin states, but how these states can be propagated through mitosis is unclear. Using immunofluorescence and biochemical fractionation, we find PcG proteins associated with mitotic chromosomes in Drosophila S2 cells. Genome-wide sequencing of chromatin immunoprecipitations (ChIP–SEQ) from mitotic cells indicates that Posterior Sex Combs (PSC) is not present at well-characterized PcG targets including Hox genes in mitosis, but does remain at a subset of interphase sites. Many of these persistent sites overlap with chromatin domain borders described by Sexton et al. (2012), which are genomic regions characterized by low levels of long range contacts. Persistent PSC binding sites flank both Hox gene clusters. We hypothesize that disruption of long-range chromatin contacts in mitosis contributes to PcG protein release from most sites, while persistent binding at sites with minimal long-range contacts may nucleate re-establishment of PcG binding and chromosome organization after mitosis.Molecular and Cellular Biolog