Minimal extension of tri-bimaximal mixing and generalized Z_2 X Z_2 symmetries

We discuss consequences of combining the effective $Z_2\times Z_2$ symmetry of the tri-bimaximal neutrino mass matrix with the CP symmetry. Imposition of such generalized $Z_2\times Z_2$ symmetries leads to predictive neutrino mass matrices determined in terms of only four parameters and leads to non-zero $\theta_{13}$ and maximal atmospheric mixing angle and CP violating phase. It is shown that an effective generalized $Z_2\times Z_2$ symmetry of the mass matrix can arise from the $A_4$ symmetry with specific vacuum alignment. The neutrino mass matrix in the considered model has only three real parameters and leads to determination of the absolute neutrino mass scale as a function of the reactor angle $\theta_{13}$.Comment: References added, accepted for publication in Phys. Rev. D (Rapid Communication

Modified mattress sutures vs running sutures in uterine closure: which is better?

Background: Conventional closure of uterus has been known to bear risk of scar dehiscence and scar rupture in subsequent pregnancies and thus, a study was conducted to compare the outcome of uterine closure with modified mattress manner and running manner and to establish a better method of uterine closure during caesarean section. Objective was to compare the conventional single layer running sutures and single layer modified mattress sutures for closure of uterus in caesarean section and find out which method is superior.Methods: This prospective interventional study was carried out in Dhiraj Hospital, a tertiary care hospital in Vadodara. 60 pregnant women in the study criteria were equally divided randomly into 2 groups. Uterine closure was done in single layered sutures, one by running sutures and other group by modified mattress sutures.Results: Uterine scar thickness on 8th day and 6 months post-operatively was significantly more in single layered suturing by modified mattress suture compared to running suture (p <0.05).Conclusions: Uterine closure by single layered modified mattress suture is better in comparison to conventional single layer running suture

Regulation of the human LAT gene by the Elf-1 transcription factor

BACKGROUND: The LAT gene encodes an intracellular adaptor protein that links cell-surface receptor engagement to numerous downstream signalling events, and thereby plays an integral role in the function of cell types that express the gene, including T cells, mast cells, natural killer cells, and platelets. To date, the mechanisms responsible for the transcriptional regulation of this gene have not been investigated. RESULTS: In this study we have mapped the transcriptional start sites for the human LAT gene and localized the 5' and 3' boundaries of the proximal promoter. We find that the promoter contains both positive and negative regulatory regions, and that two binding sites for the Ets family of transcription factors have a strong, positive effect on gene expression. Each site binds the Ets family member Elf-1, and overexpression of Elf-1 augments LAT promoter activity. The promoter also contains a Runx binding site adjacent to one of the Ets sites. This site, which is shown to bind Runx-1, has an inhibitory effect on gene expression. Finally, data is also presented indicating that the identified promoter may regulate cell-type specific expression. CONCLUSION: Collectively, these results provide the first insights into the transcriptional regulation of the LAT gene, including the discovery that the Ets transcription factor Elf-1 may play a central role in its expression

Park availability and major depression in individuals with chronic conditions: Is there an association in urban India?

Green space exposure has been positively correlated with better mental-health indicators in several high income countries, but has not been examined in low- and middle-income countries undergoing rapid urbanization. Building on a study of mental health in adults with a pre-existing chronic condition, we examined the association between park availability and major depression among 1208 adults surveyed in Delhi, India. Major depression was measured using the Mini International Neuropsychiatric Interview. The ArcGIS platform was used to quantify park availability indexed as (i) park distance from households, (ii) area of the nearest park; and within one km buffer area around households - the (iii) number and (iv) total area of all parks. Mixed-effects logistic regression models adjusted for socio-demographic characteristics indicated that relative to residents exposed to the largest nearest park areas (tertile 3), the odds [95% confidence interval] of major depression was 3.1 [1.4-7.0] times higher among residents exposed to the smallest nearest park areas (tertile 1) and 2.1 [0.9-4.8] times higher in residents with mid-level exposure (tertile 2). There was no statistically significant association between other park variables tested and major depression. We hypothesized that physical activity in the form of walking, perceived stress levels and satisfaction with the neighborhood environment may have mediating effects on the association between nearest park area and major depression. We found no significant mediation effects for any of our hypothesized variables. In conclusion, our results provide preliminary and novel evidence from India that availability of large parks in the immediate neighborhood positively impacts mental well-being of individuals with pre-existing chronic conditions, at the opportune time when India is embarking on the development of sustainable cities that aim to promote health through smart urban design - one of the key elements of which is the inclusion of urban green spaces

Association between poor oral health and diabetes among Indian adult population: potential for integration with NCDs.

BACKGROUND: Studies in high-income countries have reported associations between oral health and diabetes. There is however a lack of evidence on this association from low and middle-income countries, especially India. The current study aimed to assess the prevalence of common oral diseases and their association with diabetes. METHODS: This cross-sectional study was nested within the second Cardiometabolic Risk Reduction in South Asia Surveillance Study. A subset of study participants residing in Delhi were administered the World Health Organization's Oral Health Assessment Questionnaire and underwent oral examination for caries experience and periodontal health assessment using standard indices. Diabetes status was ascertained by fasting blood glucose, glycosylated hemoglobin values or self-reported medication use. Information was captured on co-variates of interest. The association between oral health and diabetes was investigated using Multivariable Zero-Inflated Poisson (ZIP) regression analysis. RESULTS: Out of 2045 participants, 47% were women and the mean age of study participants was 42.17 (12.8) years. The age-standardised prevalence (95% confidence interval) estimates were 78.9% (75.6-81.7) for dental caries, 35.9% (32.3-39.6) for periodontitis. Nearly 85% participants suffered from at least one oral disease. Compared to diabetes-free counterparts, participants with diabetes had more severe caries experience [Mean Count Ratio (MCR)?=?1.07 (1.03-1.12)] and attachment loss [MCR?=?1.10 (1.04-1.17)]. Also, the adjusted prevalence of periodontitis was significantly higher among participants with diabetes [42.3%(40.0-45.0)] compared to those without diabetes [31.3%(30.3-32.2)]. CONCLUSION: We found that eight out of ten participants in urban Delhi suffered from some form of oral disease and participants with diabetes had worse oral health. This highlights the need for public health strategies to integrate oral health within the existing Non-Communicable Disease control programs

Covid-19 and Ukrainian Crisis Exponentiates the Need for the Inclusion of Conflict and Disaster Medicine in Medical Curriculum

© The Author(s) 2022.Conflict medicine is an age-old branch of medicine which focuses on delivering healthcare services to the injured in the setting of conflicts, wars, disasters, and/or other calamities. The course in its purest form has been traditionally given only in military medical schools while civilian medical students are usually taught parts of the course in other overlapping subjects like surgery, infectious diseases, etc. However, in a crisis situation, civilian doctors are expected to double up as military doctors, which leads to emotional, mental, and physical stress for the civilian doctors along with logistical and organizational challenges. The current Covid-19 pandemic and the Russo-Ukrainian conflict have highlighted once again the emergent need for the implementation of conflict medicine courses in regular medical curricula, so as to make the medical students situation-ready. With our present discussion, we aim to provide a brief overview of the course, its core modules, challenges to its implementation, and possible solutions. We believe that the complex management skills gained by this course are not only useful in conflict scenario but are also valuable in managing day-to-day medical emergencies.publishersversionPeer reviewe

SARS-CoV-2 receptor binding domain displayed on HBsAg virus–like particles elicits protective immunity in macaques

Authorized vaccines against SARS-CoV-2 remain less available in low- and middle-income countries due to insufficient supply, high costs, and storage requirements. Global immunity could still benefit from new vaccines using widely available, safe adjuvants, such as alum and protein subunits, suited to low-cost production in existing manufacturing facilities. Here, a clinical-stage vaccine candidate comprising a SARS-CoV-2 receptor binding domain–hepatitis B surface antigen virus–like particle elicited protective immunity in cynomolgus macaques. Titers of neutralizing antibodies (>104) induced by this candidate were above the range of protection for other licensed vaccines in nonhuman primates. Including CpG 1018 did not significantly improve the immunological responses. Vaccinated animals challenged with SARS-CoV-2 showed reduced median viral loads in bronchoalveolar lavage (~3.4 log10) and nasal mucosa (~2.9 log10) versus sham controls. These data support the potential benefit of this design for a low-cost modular vaccine platform for SARS-CoV-2 and other variants of concern or betacoronaviruses