Subjective beliefs and decision making under uncertainty in the field

Nutrient management decision under uncertainty is a critical and complex decision that a farmer has to make on his field. It is complex as it is a decision that may be linked to several other decisions on their field. Research studies have shown that nutrient application alters the crop yield density. This indicates that nutrient is not limited to be a productive input, but it can also be used as a tool for risk management under uncertainty in agriculture. Researchers have developed models of decision making under uncertainty in agriculture and elsewhere, where strong restrictions on the decision making agents\u27 perception and preferences has been imposed to identify the underlying decision process. Similar, framework has been used for studying the farmer\u27s nutrient decision (mostly based on expected utility or expected profit maximization framework). In the process of modeling the nutrient decision, farmer\u27s perception (expectations) about the nitrogen uncertainty is artificially constructed, which is assumed by researchers to be rational expectations. It is important to note that the choice of optimal nitrogen in a field is a subjective concept, which rests upon the truth and validity of the assumptions introduced in the decision making framework. This dissertation relaxes those arbitrary assumptions about the nitrogen uncertainty by measuring the subjective uncertainty perceived by a farmer surrounding the chosen level of nitrogen. Although, the uncertainty around the chosen level of nitrogen is measured, nothing much can be said about the choice of optimal nitrogen. The subjective expectations of farmer around the optimal level of nitrogen are measured and juxtaposed with the agronomic benchmark. This dissertation is a contribution to the field by providing factual evidence about the discordance between the subjective beliefs of farmers to objective reality. More broadly, this research is an effort towards advancement of the study of agriculture decision making under uncertainty by measurement of subjective expectations of farmer in context to nitrogen yield mapping, which when combined with risk preferences of farmer may be able to identify the true underlying nitrogen decision model for a farmer

Awareness, Practice and Level of Anxiety using Coronavirus Anxiety Scale among the Indian Population regarding COVID -19 Pandemic

Abstract: The most important aspect of Public Health Emergency Preparedness (PHEP) involves the circulation of trustworthy and accurate information in the public health interest domain. Strict stringency measures such as nationwide lockdown impacted people's mental health. Hence, this study was planned to assess the knowledge, practice, and anxiety among the Indian population about the ongoing pandemic in the initial phase. Methods: A web-based cross-sectional study was conducted between August 1, 2020, to October 5, 2020. Coronavirus Anxiety Scale was used to determine dysfunctional anxiety. Results: Among 553 participants, 73.6% had overall good knowledge of COVID-19 with mean correct score of 6.9±1.1. Majority of participants (97%) wore mask regularly, and 93% of respondents regularly washed their hands with soap and water. Only 14 participants scored ?9 on CAS, suggesting probable cases of dysfunctional anxiety associated with the COVID-19 crisis. Conclusion: The knowledge and practices of citizens in a nation reflect their preparedness and ability to deal with a pandemic of such proportion. Good knowledge translates to good practices and therefore reduces anxiety among the population. It is deemed necessary that people's knowledge and habits, including the mental impact, be accessed at periodic intervals to track their adaptation to pandemics over time

Impact of health education on knowledge and attitude of self-breast examination among female nursing students

Background: Breast cancer is the most common cancer among women and a leading cause of death worldwide, including in India. Breast cancer usually shows a slow development rate, and when it is recognized in the early stages, successful treatment results can be achieved. Breast self-examination is a screening option for young women. Health awareness programs on screening and early detection are the cornerstones for reducing the morbidity and mortality resulting from breast cancer. Objective: To assess the impact of health education on knowledge and attitude of self-breast examination among nursing students. Study Design: The present interventional study was conducted between September and October 2019. Setting: This study was done among 79 nursing students of a tertiary care hospital situated in a central district of Uttar Pradesh. Main Outcome Measures: The self-reported pre-designed and structured questionnaire was used. It included three sections: 1. Sociodemographic profile 2. Knowledge regarding self-breast examination (SBE) 3. Attitude regarding self-breast examination (SBE). Knowledge and attitude scores were calculated and divided into the poor, average, and good categories. Results: There were 87.3% of girls had prior knowledge of the self-breast examination, while 12.7% of girls were not aware of the self-breast examination. Post-intervention, there was a significant increase (p<0.05) in their knowledge about self-breast examination. Conclusion and Relevance: Planned teaching intervention had a significant impact on the knowledge and attitude of self-breast examination. The knowledge and attitude were poor at the early stages, but it had increased significantly after the health education intervention

Hemoglobin receptor in Leishmania is a hexokinase located in the flagellar pocket

Hb endocytosis in Leishmania is mediated through a 46-kDa protein located in the flagellar pocket. To understand the nature of the Hb receptor (HbR), we have purified the 46-kDa protein to homogeneity from Leishmania promastigote membrane. Purified HbR specifically binds Hb. The gene for HbR was cloned, and sequence analysis of the full-length HbR gene indicates the presence of hexokinase (HK) signature sequences, ATP-binding domain, and PTS-II motif. Four lines of evidence indicate that HbR in Leishmania is a hexokinase: 1) the recombinant HbR binds Hb, and the Hb-binding domain resides in the N terminus of the protein; 2) recombinant proteins and cell lysate prepared from HbR-overexpressing Leishmania promastigotes show enhanced HK activity in comparison with untransfected cells; 3) immunolocalization studies using antibodies against the N-terminal fragment (Ld-HbR-ΔC) of Ld-HbR indicate that this protein is located in the flagellar pocket of Leishmania; and 4) binding and uptake of 125I-Hb by Leishmania is significantly inhibited by anti-Ld-HbR-ΔC antibody and Ld-HbR-ΔC, respectively. Taken together, these results indicate that HK present in the flagellar pocket of Leishmania is involved in Hb endocytosis

Role of Nephrostomy in poorly functioning kidneys in patients with ureteropelvic junction obstruction (UPJO)

Introduction: Several studies have addressed the unique management challenges in poorly functioning kidneys of patients with ureteropelvic junction obstruction. Trial with percutaneous drainage of such kidneys as a guide to choose the type of surgical management would be a solution to this dilemma. We aimed to evaluate the role of percutaneous nephrostomy in treatment of poorly functioning kidneys in pediatric patients with UPJO.Materials and Methods: A prospective study was performed on patients with poorly functioning kidneys (split renal function<10% on renal dynamic scan) and unilateral ureteropelvic junction obstruction from August 2016 to January 2018. Ultrasound-guided nephrostomy was inserted for these patients. Data regarding the differential renal function and glomerular function rate (GFR) was collected before and after nephrostomy insertion. Decision regarding pyeloplasty or nephrectomy of the involved kidney was made based on changes seen in differential function and Glomerular filtration rate following the drainage.Results: Thirty three patients with unilateral UPJO with poorly functioning kidneys were treated during this period. Thirty patients had significant increase in differential function and glomerular filtration rate. These patients underwent pyeloplasty. In 2 patients, these parameters did not increase much and they underwent nephrectomy. One patient had an infected kidney which did not improve significantly on drainage and had to be removed. Of the 30 patients who had pyeloplasty, two developed obstruction after 3 months of removal of double-J stent and needed reoperation.Conclusion: Percutaneous nephrostomy in poorly functioning kidneys with ureteropelvic junction obstruction helps to identify potentially salvageable kidneys which merit pyeloplasty. Kidneys which do not improve with nephrostomy are unlikely to improve with pyeloplasty and therefore nephrectomy is done in such cases.

Quantification of Thermal Oxidation in Metallic Glass Powder using Ultra-small Angle X-ray Scattering

In this paper, the composition, structure, morphology and kinetics of evolution during isothermal oxidation of Fe 48Cr 15Mo 14Y 2C 15B 6 metallic glass powder in the supercooled region are investigated by an integrated ex-situ and in-situ characterization and modelling approach. Raman and X-ray diffraction spectra established that oxidation yielded a hierarchical structure across decreasing length scales. At larger scale, Fe 2O 3 grows as a uniform shell over the powder core. This shell, at smaller scale, consists of multiple grains. Ultra-small angle X-ray scattering intensity acquired during isothermal oxidation of the powder over a wide Q-range delineated direct quantification of oxidation behavior. The hierarchical structure was employed to construct a scattering model that was fitted to the measured intensity distributions to estimate the thickness of the oxide shell. The relative gain in mass during oxidation, computed theoretically from this model, relatively underestimated that measured in practice by a thermogravimetric analyzer due to the distribution in sizes of the particles. As a whole, this paper introduces the first direct quantification of oxidation in metallic glass powder by ultra-small angle X-ray scattering. It establishes novel experimental environments that can potentially unfold new paradigms of research into a wide spectrum of interfacial reactions in powder materials at elevated temperatures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication