Conflict in Cross Border Mergers Effect of Firm and Market Size

This paper tries to analyze the interrelationship between possibilities of conflict in cross border mergers and acquisitions and firm and market characteristics in a two country three firm model. We show that in general an increase in asymmetry across firms reduces the possibility of conflict between jurisdictions over merger review decisions. We also show that possibility of conflict increase with the increase in market asymmetries across countries. We also discuss interaction of asymmetry in firm and market size with the distribution of firms across countries and its effect on the possibilities of conflict.conflict, Cross border mergers, firm size, Market Size

Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

Background: Estimation of HbA1c in gestational diabetes mellitus patients is not being recommended by any societies/guidelines as studies regarding the role of HbA1c for monitoring of euglycemic control and predicting the maternal and perinatal outcomes in GDM patients (unlike overt diabetes) are conflicting and sparse.Methods: This was a prospective study with an aim to evaluate the role of HbA1c estimation in late pregnancy (early and late third trimester) for prediction of pregnancy outcomes in GDM patients. 53 patients with GDM (diagnosed before third trimester) were recruited for the study. HbA1c levels were estimated in late pregnancy (at 28-32 weeks and again repeated at 37 - 39 weeks or at the time of delivery). Correlation of HbA1c levels in third trimester with maternal and perinatal outcome was studied in patients with gestational diabetes mellitus and cut off taken was 5.8%.Results: Of the total 53 patients 54.7% had HbA1c levels <5.8% and 45.3% had HbA1c ≥5.8% done at 28-32 weeks. Also when HbA1c levels done at 37-39 weeks POG/ at the time of delivery, 52.8% patients had <5.8% and 47.2% had HbA1c ≥5.8%. Approximately one-fourth of the patients had HbA1c ≥ 5.8% even with normal blood sugar levels (euglycemic) control. There was statistically significant increased incidence of polyhydramnios, LGA (large for gestational age babies) and increased mean birth weight in patients with HbA1c ≥ 5.8%, done in late pregnancy. However there was no statistically significant difference in the incidence of preterm labour, gestational hypertension or preeclampsia, urinary tract infections, vulvovaginal infections, caesarean deliveries and postpartum haemorrhage in patients with HbA1c ≥5.8% compared to patients with HbA1c <5.8%.Conclusions: The study revealed that in patients of GDM with HbA1c levels ≥5.8% done in third trimester was statistically significantly associated with increased incidence of polyhydramnios, large for gestational age babies and increased mean birth weight when compared to patients with HbA1c <5.8%

To study the clinicoetiological profile of children admitted with bleeding diathesis

&nbsp;Background: Bleeding complications in children may be caused by disorders of secondary hemostasis or fibrinolysis. A child who&nbsp;presents with bleeding warrants evaluation for a significant bleeding problem. Objectives: The aim is to study the clinicoetiological&nbsp;profile of children admitted with bleeding diathesis. Materials and Methods: Children up to the age of 14 years presenting in&nbsp;the Department of Pediatrics, Pandit B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, with hemorrhagic diathesis,&nbsp;that is, non-traumatic spontaneous bleeding, suspected to be either due to the defective primary hemostatic mechanism (platelet–&nbsp;blood vessel interaction) or defective secondary hemostatic mechanism, were enrolled for this study. Frequency distribution of&nbsp;various bleeding disorders in various age groups was studied. Results: A total of 92 children up to the age of 14 years were taken&nbsp;up for study, of which, maximum cases with bleeding presented with hematemesis (23.9%) followed by melena (22.8%). A total&nbsp;of 73 children (79.34%) presented with skin and joint bleeds. We were able to make diagnosis in 82 children (89.1%). Among&nbsp;82 patients, 31 (37.8%) had bleeding secondary to infections, 11 (13.4%) had coagulation disorder, 9 (10.97%) had Henoch–Schonlein purpura (HSP) and immune thrombocytopenic purpura (ITP) each, 6 (7.3%) had hypoplastic bone marrow, 2 (2.4%) had&nbsp;chronic malaria, 4 (4.9%) had leukemia, 6 (7.3%) had liver diseases, and 6 (7.3%) had hemorrhagic disease of newborn (HDN).&nbsp;Almost half of the children with bleeding manifestations in each age group had thrombocytopenia. The most common causes of&nbsp;bleeding in &lt;1 year were septicemia with thrombocytopenia and HDN; among 1-7 years were infections, ITP, and coagulation&nbsp;disorders; and in more than 7 years were HSP, ITP, liver disease, and hemolytic-uremic syndrome. Conclusion: Our study foundthat the gastrointestinal tract was the most common site of bleeding in children presenting with non-traumatic spontaneous bleed,&nbsp;and thrombocytopenia was present in 50% of the cases in each age group. We also found that infections were the most common&nbsp;cause of bleeding in younger children, whereas immunological causes and coagulation disorders predominate in older children.&nbsp;Hence, while evaluating any child with bleeding, age at presentation is also an important parameter to find the etiological diagnosis.&nbsp

Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India

Background: This study aims to determine the maternal complications in twin pregnancy in North Indian population at tertiary institute.Methods: This was a retrospective cohort review of multiple pregnancies after 20 weeks gestation at a tertiary teaching hospital (2011-2015). Maternal data was collected from the labor room delivery data entry register and patient’s admission file. Patients with diabetes mellitus and chronic hypertension were excluded from the study.Results: Out of 19539 births during this period, 432 were twin pregnancies with an incidence of 22/1000 birth. Most of them were 282 (65.4%) were referred patients. Eighty seven percent patients were in the age group of 21-30 years and primigravida contributed to 45.7% of total patients. Maternal complications noticed were as preterm deliveries in 304 (70%), anaemia in 259(60%) patients, preterm rupture of membranes in 120 (39.4%) patients, hypertensive disorders of pregnancy in 122(28.3%) patients, cholestasis of pregnancy in 24(5.5%) of patients, hypothyroidism in 22(5.1%) of patients, antepartum hemorrhage (APH) in 20(4.6%) and gestational diabetes mallitus (GDM) in 08(1.8%) of patients. Among postpartum complications, atonic postpartum haemorrhage (PPH) was observed in 44 (10.2%) and maternal mortality happened in 02(0.46%) cases.Conclusions: This study reveals higher percentage of, preterm labor, anaemia, and gestational hypertension than other studies. More number of intensive care unit should be established in high prevalence areas to prevent perinatal mortality due to prematurity. Treatment of anaemia requires more aggressive approach by considering intravenous iron whenever compliance is in doubt. Frequent antenatal care is required for early diagnosis of these complications to prevent maternal and fetal morbidity

Study of endothelial function in pregnant women with gestational diabetes mellitus by flow mediated dilation of brachial artery

Background: The objective of the study was to assess vascular function in normal pregnant women and women with gestational diabetes and to study its temporal relationship with gestational age at 24-28-week POG and at 36-38-week POG and changes in FMD in postpartum period.Methods: Assessment of vascular function was done at 24-28-week POG, 36-38-week POG and at 6-12-week postpartum by flow mediated dilation of brachial artery in 37 healthy pregnant women and 37 pregnant women with GDM.Results: In GDM group mean FMD at 24-28 weeks of POG, at 36-38 weeks POG was lower as compared to the control group (11.225±6.20,8.464±6.09 versus 14.49±5.21, 10.898±4.12) although the difference in mean FMD in two groups was not statistically significant. It was found that the decrease in FMD at 36-38-week POG as compared to 24-28 weeks POG was statistically significant in both the groups (p&lt;0.001).Conclusions: This study revealed that when endothelial function as assessed by FMD was compared at different period of gestation, the mean decrease in FMD at 36-38-week POG as compared to 24-28-week POG and 6-week post-partum was statistically significant in patients with GDM and as well as the control group, however this trend of change was same in both the groups and was not statistically significant when compared between the two group (GDM versus control). A negative correlation of FMD was found with BMI, and HBA1c, that was stronger in GDM group

Umbilical cord cyst: a diagnostic dilemma

Umbilical cord cyst refers to any cystic lesion associated with the umbilical cord. Cord cysts can be defined as true or false cysts and may occur in any location along the cord. They are irregular in shape and are located between the cord vessels. Authors are reporting the case of an infant with an umbilical cord tumor which had twice been misdiagnosed previously as a hemangioma, based on ultrasound image of its cystic and solid component with good vascular supply. The ultrasound image most likely suggestive of a hemangioma as a differential diagnosis led to caesarean section in our patient (based on large size of the lesion and fear of rupture of same during process of labour). The definitive diagnosis was made only after birth of the baby. Final diagnosis of true umbilical cord cyst was made after histopathological examination. Thus, there can be confusion in the diagnosis between umbilical cord hemangiomas and umbilical cord cysts based on ultrasound

Association of vitamin D deficiency during pregnancy with preeclampsia and eclampsia

Background: Vitamin D was considered important for bone and calcium. Historically thought to be important for bone and calcium metabolism but recent studies have redefined its role. There is some evidence now that low levels of Vitamin D are associated with the risk of preeclampsia but more studies are needed to prove the same. This study was done to determine whether vitamin D deficiency is an independent risk factor for preeclampsia/eclampsia.Methods: In this prospective case control study vitamin D levels were estimated in 92 women divided into two groups. Group 1(n = 42) included pregnant women with preeclampsia/eclampsia and group 2(n = 50) included uncomplicated pregnant women admitted in labour ward for delivery. The frequency of risk factors for preeclampsia/eclampsia were compared in two groups. Statistical analysis was done using the multivariate logistic regression analysis.Results: Almost 100% women in both groups had low vitamin D levels. Mean serum 25(OH)D levels were significantly less in Group 1(6.7236ng/ml) as compared to group 2(9.8862 ng/ml, p = 0.004). 83.3% of women in group 1 had severe deficiency (25(OH)D levels <10 ng/ml) compared to 68% women in group 2. All women (100%) in group 1 had vitamin D deficiency (<20 ng/ml) as compared to 92% in group 2 but this was not statistically significant.Conclusions: Although mean serum 25(OH)D levels were significantly less in preeclampsia/eclampsia group, prevelance of vitamin D deficiency was not significantly different in pregnant women with preeclampsia/eclampsia as compared to women who did not have preeclampsia/eclampsia

OsJAZ11 regulates phosphate starvation responses in rice

Main conclusion: OsJAZ11 regulates phosphate homeostasis by suppressing jasmonic acid signaling and biosynthesis in rice roots. Abstract: Jasmonic Acid (JA) is a key plant signaling molecule which negatively regulates growth processes including root elongation. JAZ (JASMONATE ZIM-DOMAIN) proteins function as transcriptional repressors of JA signaling. Therefore, targeting JA signaling by deploying JAZ repressors may enhance root length in crops. In this study, we overexpressed JAZ repressor OsJAZ11 in rice to alleviate the root growth inhibitory action of JA. OsJAZ11 is a low phosphate (Pi) responsive gene which is transcriptionally regulated by OsPHR2. We report that OsJAZ11 overexpression promoted primary and seminal root elongation which enhanced Pi foraging. Expression studies revealed that overexpression of OsJAZ11 also reduced Pi starvation response (PSR) under Pi limiting conditions. Moreover, OsJAZ11 overexpression also suppressed JA signaling and biosynthesis as compared to wild type (WT). We further demonstrated that the C-terminal region of OsJAZ11 was crucial for stimulating root elongation in overexpression lines. Rice transgenics overexpressing truncated OsJAZ11ΔC transgene (i.e., missing C-terminal region) exhibited reduced root length and Pi uptake. Interestingly, OsJAZ11 also regulates Pi homeostasis via physical interaction with a key Pi sensing protein, OsSPX1. Our study highlights the functional connections between JA and Pi signaling and reveals JAZ repressors as a promising candidate for improving low Pi tolerance of elite rice genotypes

Feasibility of supervised self-testing using an oral fluid-based HIV rapid testing method:a cross-sectional, mixed method study among pregnant women in rural India

Introduction: HIV self-testing can increase coverage of essential HIV services. This study aimed to establish the acceptability, concordance and feasibility of supervised HIV self-testing among pregnant women in rural India. Methods: A cross-sectional, mixed methods study was conducted among 202 consenting pregnant women in a rural Indian hospital between August 2014 and January 2015. Participants were provided with instructions on how to self-test using OraQuick® HIV antibody test, and subsequently asked to self-test under supervision of a community health worker. Test results were confirmed at a government-run integrated counselling and testing centre. A questionnaire was used to obtain information on patient demographics and the ease, acceptability and difficulties of self-testing. In-depth interviews were conducted with a sub-sample of 35 participants to understand their experiences. Results: In total, 202 participants performed the non-invasive, oral fluid-based, rapid test under supervision for HIV screening. Acceptance rate was 100%. Motivators for self-testing included: ease of testing (43.4%), quick results (27.3%) and non-invasive procedure (23.2%). Sensitivity and specificity were 100% for 201 tests, and one test was invalid. Concordance of test result interpretation between community health workers and participants was 98.5% with a Cohen’s Kappa (k) value of k=0.566 with p<0.001 for inter-rater agreement. Although 92.6% participants reported that the instructions for the test were easy to understand, 18.7% required the assistance of a supervisor to self-test. Major themes that emerged from the qualitative interviews indicated the importance of the following factors in influencing acceptability of self-testing: clarity and accessibility of test instructions; time-efficiency and convenience of testing; non-invasiveness of the test; and fear of incorrect results. Overall, 96.5% of the participants recommended that the OraQuick® test kits should become publicly available. Conclusions: Self-testing for HIV status using an oral fluid-based rapid test under the supervision of a community health worker was acceptable and feasible among pregnant women in rural India. Participants were supportive of making self-testing publicly available. Policy guidelines and implementation research are required to advance HIV self-testing for larger populations at scale

Hydraulic flux–responsive hormone redistribution determines root branching

Plant roots exhibit plasticity in their branching patterns to forage efficiently for heterogeneously distributed resources, such as soil water. The xerobranching response represses lateral root formation when roots lose contact with water. Here, we show that xerobranching is regulated by radial movement of the phloem-derived hormone abscisic acid, which disrupts intercellular communication between inner and outer cell layers through plasmodesmata. Closure of these intercellular pores disrupts the inward movement of the hormone signal auxin, blocking lateral root branching. Once root tips regain contact with moisture, the abscisic acid response rapidly attenuates. Our study reveals how roots adapt their branching pattern to heterogeneous soil water conditions by linking changes in hydraulic flux with dynamic hormone redistribution