Nasal and hand carriage of bacteria in different groups of persons in a teaching hospital in India

275 persons of different categories were studiedfor nasal and hand carnage of different pathogenic bacteria. Overall carriage rate was 54.5%. Doc­tors and paramedical staff had higher bacterial carriage rate in comparison to other groups. Though Staphylococcus aureus iwu the commonest or­ganism isolated from both nose and skin, earners of Escherichia coli. Pseudomonas and Klebsiella group ofgramnegative bacilli was also observed. Nasal carrier were commonest than dermal carriag

Considerations of private sector obstetricians on participation in the state led “Chiranjeevi Yojana” scheme to promote institutional delivery in Gujarat, India: a qualitative study

Background In India a lack of access to emergency obstetric care contributes to maternal deaths. In 2005 Gujarat state launched a public-private partnership (PPP) programme, Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians a fixed fee for providing free intrapartum care to poor and tribal women. A million women have delivered under CY so far. The participation of private obstetricians in the partnership is central to the programme’s effectiveness. We explored with private obstetricians the reasons and experiences that influenced their decisions to participate in the CY programme. Method In this qualitative study we interviewed 24 purposefully selected private obstetricians in Gujarat. We explored their views on the scheme, the reasons and experiences leading up to decisions to participate, not participate or withdraw from the CY, as well as their opinions about the scheme’s impact. We analysed data using the Framework approach. Results Participants expressed a tension between doing public good and making a profit. Bureaucratic procedures and perceptions of programme misuse seemed to influence providers to withdraw from the programme or not participate at all. Providers feared that participating in CY would lower the status of their practices and some were deterred by the likelihood of more clinically difficult cases among eligible CY beneficiaries. Some providers resented taking on what they saw as a state responsibility to provide safe maternity services to poor women. Younger obstetricians in the process of establishing private practices, and those in more remote, ‘less competitive’ areas, were more willing to participate in CY. Some doctors had reservations over the quality of care that doctors could provide given the financial constraints of the scheme. Conclusions While some private obstetricians willingly participate in CY and are satisfied with its functioning, a larger number shared concerns about participation. Operational difficulties and a trust deficit between the public and private health sectors affect retention of private providers in the scheme. Further refinement of the scheme, in consultation with private partners, and trust building initiatives could strengthen the programme. These findings offer lessons to those developing public-private partnerships to widen access to health services for underprivileged groups

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Privacy-aware supervised classification: An informative subspace based multi-objective approach

Sharing the raw or an abstract representation of a labelled dataset on cloud platforms can potentially expose sensitive information of the data to an adversary, e.g., in the case of an emotion classification task from text, an adversary-agnostic abstract representation of the text data may eventually lead an adversary to identify the demographics of the authors, such as their gender and age. In this paper, we propose a universal defence mechanism against such malicious attempts of stealing sensitive information from data shared on cloud platforms. More specifically, our proposed method employs an informative subspace based multi-objective approach to obtain a sensitive information aware encoding of the data representation. A number of experiments conducted on both standard text and image datasets demonstrate that our proposed approach is able to reduce the effectiveness of the adversarial task (i.e., in other words is able to better protect the sensitive information of the data) without significantly reducing the effectiveness of the primary task itself

Structure-property correlation of a new family of organogelators based on organic salts and their selective gelation of oil from oil/water mixtures

Organic salts based on dicyclohexylamine and substituted/unsubstituted cinnamic acid exhibit efficient gelation of organic fluids, including selective gelation of oil from an oil/water mixture. Among the cinnamate salts, dicyclohexylammonium 4-chlorocinnamate (1), 3-chlorocinnamate (2), 4-bromocinnamate (3), 3-bromocinnamate (4), 4-methylcinnamate (5) and the parent cinnamate (6) are gelators, whereas 2-chlorocinnamate (7), 2-bromocinnamate (8), 3-methylcinnamate (9), 2-methylcinnamate (10) and hydrocinnamate (11) are non-gelators. Non-gelation behaviour of 11 and various benzoate derivatives 12–18 indicate the significance of an unsaturated backbone in the gelation behaviour of the cinnamate salts. A structure–property correlation based on the single-crystal structures of most of the gelators (1, 3, 5 and 6) and non-gelators, such as 7, 8, 10–18, indicates that the prerequisite for the one-dimensional (1D) growth of the gel fibrils is mainly governed by the 1D hydrogen-bonded network involving the ion pair. All the non-gelators show either two- (2D) or zero-dimensional (0D) hydrogen-bonded assemblies involving the ion pair. The molecular packing of the fibres in the xerogels of 1, 3, 5 and 6 has also been established on the basis of their simulated powder diffraction patterns, XRPD of bulk solids and xerogels. Ab initio quantum chemical calculations suggests that π–π interactions is not a contributing factor in the gelation process

Single-Crystal-to-Single-Crystal Breathing and Guest Exchange in Co^II Metal–Organic Frameworks

Single-crystal-to-single-crystal (SCSC) breathing and guest exchange properties of a series of Co^II metal–organic frameworks (MOFs) are reported. A new bis-pyridyl-bis-amide ligand, namely 4,4′-oxybis­(<i>N</i>-(pyridine-4-yl)­benzamide) (<b>LP1</b>), produced two MOFs, namely [{Co­(LP1)­(IPA)}­(DMF)₂(H₂O)]_∞ (<b>1</b>) and [{Co₂(LP1)₂(TPA)₂}­(DMF)₄]_∞ (<b>2</b>) under solvothermal conditions (IPA = isophthalate, TPA = terephthlate). While <b>1</b> showed excellent SCSC breathing responsive to both heat and guests (acetone, DMSO, MeOH, DEF), <b>2</b> displayed no breathing under similar conditions. However, it showed excellent SCSC guest (acetone, DMSO) exchange properties. Single-crystal structural analyses revealed that the conformational flexibility of the ligand <b>LP1</b> played a crucial role both in breathing in <b>1</b> and in guest exchange in <b>2</b>. Compound <b>1</b> also displayed heat responsive magnetic changes

Probing the O⋯Br–Br halogen bonding in X-ray crystal structures with ab initio calculations

Halogen bonding is a class of non-covalent interaction in which a halogen atom interacts with an electronegative atom such as oxygen or nitrogen in an attractive fashion. In this work, we investigate the X-ray crystallographically observed non-bonded C–O⋯Br–Br interactions with methanol, 1,4-dioxane and acetone by quantum chemical calculations. The C–O⋯Br–Br interaction was further extended with dimethyl ether, 1,3-dioxane and formaldehyde. The CBS-QB3 calculated results show that the oxygen and bromine non-bonded interactions are in the order of 3–5 kcal mol−1, which are comparable to the typical O–H⋯O and N–H⋯O type hydrogen bond strengths [S. J. Grabowski, Chem. Rev., 2011, 111, 2597]. The AIM calculations show good correlation between the density at the intermolecular critical point and the interaction energy. This study has also explored the directionality of bromine molecule addition to the lone pairs at the sp2 and sp3 oxygen atoms of methanol, 1,4-dioxane, acetone, dimethyl ether, 1,3-dioxane and formaldehyde. The calculated results show that the directionality of bromine molecules towards interacting with the oxygen atoms of 1,4-dioxane and acetone is in accord with the observed X-ray crystal structure analysis. However, in the case of methanol, the approach of the bromine molecule seems to be influenced by the crystal forces. The influence of stereoelectronic effects towards the approach of the bromine molecule to 1,3-dioxane is more prominent than that of the 1,4-dioxane system. The existence and magnitude of the positive regions (σ-hole) on the other side of the bromine molecule complexed with the donor molecule seem to facilitate the bridge formation as observed in the X-ray crystal structures

Tandem cyclization−cycloaddition behavior of rhodium carbenoids with carbonyl compounds: stereoselective studies on the construction of novel epoxy-bridged tetrahydropyranone frameworks

Investigations and stereoselective studies on the tandem reactions of carbonyl ylides generated from α-diazo ketones in the presence of carbonyl compounds are presented in this paper. Intramolecular cyclization of rhodium carbenoids generated the transient five- or six-membered-ring carbonyl ylide dipoles, which efficiently underwent 1,3-dipolar cycloaddition reactions with various dipolarophiles such as aromatic aldehydes 15, α,β-unsaturated aldehydes 18/24, α,β-unsaturated ketones 27/28/31, and dienone 34. The transient carbonyl ylides underwent cycloadditions with various aromatic aldehydes to furnish diverse epoxy-bridged tetrahydropyranone ring systems in a diastereoselective manner. The cycloaddition of carbonyl ylides with α,β-unsaturated aldehydes 18/24 or dienone 34 afforded C&#x2550;O addition products in a chemoselective manner despite the presence of C&#x2550;C bonds in the above dipolarophiles. Alternatively, the cycloaddition of carbonyl ylides with α,β-unsaturated ketones 27/28 provided both the C&#x2550;O and C&#x2550;C cycloaddition products. The cycloaddition of carbonyl ylides with carbonyl compounds occurred in good yields and was found to be highly regio- and stereoselective. Single-crystal X-ray analyses were performed to unambiguously establish the structure and stereochemistry of the novel epoxy-bridged tetrahydropyranone ring systems 35a/38. Compound 35a exhibited both intermolecular C−H···O and intramolecular C−H···π interaction motifs in the solid-state architecture. The regio-, chemo-, and stereoselectivity observed in these reactions have been investigated by semiempirical AM1 MO calculations. FMO analyses and transition state calculations have been performed for the cycloaddition of carbonyl ylides with α,β-unsaturated carbonyl compounds such as tetracyclone (34) and cyclopentenone (27a). Both FMO and transition state calculations correctly predicted the regio- and stereochemistry of the cycloadducts. The calculations further revealed that a severe steric interaction caused by the phenyl rings present in dipolarophile 34 with dipole 14a increases the activation barrier of the transition state during the cycloaddition process

Willingness to Accept the COVID-19 Vaccine and Related Factors among Indian Adults: A Cross-Sectional Study

To achieve herd immunity to a disease, a large portion of the population needs to be vaccinated, which is possible only when there is broad acceptance of the vaccine within the community. Thus, policymakers need to understand how the general public will perceive the vaccine. This study focused on the degree of COVID-19 vaccine hesitancy and refusal and explored sociodemographic correlations that influence vaccine hesitancy and refusal. A cross-sectional online survey was conducted among the adult population of India. The survey consisted of basic demographic questions and questions from the Vaccination Attitudes Examination (VAX) Scale. Multinomial logistical regression was used to identify correlates of vaccine hesitancy and refusal. Of the 1582 people in the study, 9% refused to become vaccinated and 30.8% were hesitant. We found that both hesitancy and refusal predictors were nearly identical (lower socioeconomic status, female gender, and older age groups), except for three groups (subjects aged 45–64 years, those with approximate income <10,000 INR/month, and those residing in rural households) that showed slightly higher odds of vaccine hesitancy than refusal. We need to address the underlying sociodemographic determinants and formulate public awareness programs to address specific subgroups that are at higher risk of rejecting the vaccine and convert those who are undecided or hesitant into those willing to accept the vaccine