Seed-borne infestation and management of Alternaria Species in mustard seed at Chitwan district, Nepal

Alternaria blight in mustard cause heavy damage to the foliar parts resulting into poor growth and development of plants and thereby reduces seed yield.  Inorder to manage Alternaria infestation in mustard seed for yield maximization, an experiment was conducted in the plant protection laboratory in Nepal Polytechnic Institute, Bharatpur, Chitwan in 2018, using Completely Randomized Design (CRD) with four replicates. Five treatments i.e.Uthane M-45 (2g/kg), Neem powder (3 g/kg), Bojho powder (4g/kg), Trichoderma harzianum, (107 Conidia/mL) and control (without treatment) were used for seed treatment of local variety of Mustard. Four hundred seeds for each treatment (25 seeds in each petriplate) were plated using triple layers of moistened blotter paper in  petriplate and incubated at (27±20C) for 2 days and followed deep freezing for 24 hrs. Data of disease incidence and seed germination were recorded in 3, 7 and 10 days after incubation (DAI). Seedling vigor and seedling weight were also recorded at 5 DAI. The percentage of Alternaria spp incidence on seeds at different DAI showed highly significant with respect to different treatments. Application of Uthane M-45 and T. harzianum significantly reduced the seed-borne infection of Alternaria spp. as compared to control.  At 3 DAI Uthane M-45 completely checked the pathogen however, only 4% and 5% disease incidence was observed in 7 DAI and 10 DAI respectively. Bio control agent Trichoderma harzianum was found next best alternative after Uthane M-45 to control disease. Plant extract Bojho powder and Neem powder were found better than control to check the disease. Furthermore, highest germination (76%) was observed in Trichoderma treatment whereas, lowest germination was found in control

Stillbirth at Patan Hospital, Nepal

Introductions:  Stillbirth (SB) is one of the most common adverse outcomes of pregnancy.  The aim of this study was to determine the SB rate and to identify the likely causes contributing to SB. Methods: This cross-sectional study was conducted at Patan Hospital from 15th June 2014 to 14th June 2017 for all the cases of SBs, at or after 22 weeks, birth weight of 500 gm or more. The perinatal outcome, demographic profile, fetal characteristics, causes and contributing factors were analyzed. Results: There were 262 SB out of total 23069 deliveries, (11.24 per 1000) and 119 (46.12%) had antenatal check-up (ANC) at Patan Hospital. The 214 (82.95%) SB were among 20-34 years mothers, 133 (51.55%) being multigravida. Antepartum SB were 234 (89.31%), macerated 213 (81.30%), birth weight <1000gm 86 (32.82%) and male 156 (59.54%).  The intrauterine growth restriction (IUGR) was present in 60 (22.90%), unexplained casue in 43 (16.41%), prematurity 28 (10.69%), congenital anomalies 26 (9.92%), pre-eclampsia 19 (7.25%), gestational diabetes, and abruptio placenta each 13 (4.96%). Delay in seeking care in 202 (78.30%) was a potential contributing factor. Conclusions:  The SB was 11.24/1000 births. The causes in descending order were IUGR, unexplained, prematurity, congenital anomalies, pre-eclampsia, gestational diabetes and abruptio placenta. Delay in seeking care was found as a potential contributing factor. Keywords:  antenatal check-up (ANC), birth weight, intrauterine growth restriction (IUGR), stillbirt

Pregnancy Outcome Among Primigravidae Aged 35 Years and Above: A Comparative Study

Introduction: Maternal age is an important determinant of pregnancy outcome. Women aged 35 years ormore at their first pregnancy are considered high risk as they are associated with increased adverse maternaland perinatal outcomes. Methods: A retrospective, comparative study was carried out over a period of two years in a tertiary center. Each elderly primigravida was matched with two primigravidwomen aged 20-34 years who delivered during the same period. Secondary data on obstetric outcomes (diabetes, oligohydramnios, polyhydramnios, hypothyroidism), postpartum complications (post-partum hemorrhage, postpartum eclampsia) and perinatal outcome (intra-uterine growth restriction, prematurity, congenital anomalies, and neonatal death)of 82 elderly primigravidae (study group) was compared to 164 younger primigravida (control group) delivered during the period of study. The Chi Square test and Fisher’s Exact test were used for statistical analysis and p value of <0.05 was taken as level of significance. Results: During the study period, there were 15,012 deliveries and 82 of these were elderly primigravidae giving an incidence of 0.55%. The mean age of the elderly primigravidae was 36.8±2.16 years. The study group had more antepartum complications with preterm labor, diabetes in pregnancy, hypertensive disorders in pregnancy, multiple pregnancy and polyhydramnios (p<0.05). Seventy-one elderly primigravidae were delivered by caesarean section, the commonest indication being maternal request. The study group had higher incidence of post-partum hemorrhage but no perinatal mortality of significant proportion. Conclusion: Maternal age at the first pregnancy influences pregnancy and neonatal outcomes. Hence, elderly primigravidae should be considered as high risk and followed up accordingly

Knowledge and practice of hand hygiene among the doctors of Patan Hospital, Nepal

Introduction: Hand hygiene is the most effective infection prevention measure. This research aims to find out the knowledge and practice of hand hygiene among the doctors of major departments of Patan Hospital. Method: A cross-sectional study was conducted among doctors of selected departments of Patan Hospital, Lalitpur, Nepal. The knowledge of hand hygiene was assessed using a WHO knowledge questionnaire. The practice was assessed using a WHO observation checklist. The data was recorded in Epi-info and the analysis was done for knowledge score and compliance with practice using SPSS v15. A p-value of <0.05 was considered statistically significant. Result: A total of 104 (98%) of the participants completed each part (knowledge and practice) of the study. The overall mean score (± SD) was 64% ± 8 on knowledge questions about hand hygiene. Knowledge of hand hygiene was not significantly different among departments (p=0.351) and gender (p=0.994). Out of 1022 opportunities, the compliance of hand hygiene among the doctors was 532(52%). The highest compliance for hand hygiene was after exposure to body fluids 93%. The mean time taken for hand rub was 8 seconds and the mean steps performed were 4 out of 8. Compliance with hand hygiene was statistically significant among departments (p= 0.001). However, it was not statistically significant among gender(p=0.198). Conclusion: Participants performed relatively well with a moderate score (64%) on knowledge questions but it was not reflected in practice (overall compliance 52%). The majority performed hand hygiene after body fluid exposure (93%) and after touching patients (64%)

Activate or inhibit? Implications of autophagy modulation as a therapeutic strategy for Alzheimer’s disease

Neurodegenerative diseases result in a range of conditions depending on the type of proteinopathy, genes affected or the location of the degeneration in the brain. Proteinopathies such as senile plaques and neurofibrillary tangles in the brain are prominent features of Alzheimer’s disease (AD). Autophagy is a highly regulated mechanism of eliminating dysfunctional organelles and proteins, and plays an important role in removing these pathogenic intracellular protein aggregates, not only in AD, but also in other neurodegenerative diseases. Activating autophagy is gaining interest as a potential therapeutic strategy for chronic diseases featuring protein aggregation and misfolding, including AD. Although autophagy activation is a promising intervention, over-activation of autophagy in neurodegenerative diseases that display impaired lysosomal clearance may accelerate pathology, suggesting that the success of any autophagy-based intervention is dependent on lysosomal clearance being functional. Additionally, the effects of autophagy activation may vary significantly depending on the physiological state of the cell, especially during proteotoxic stress and ageing. Growing evidence seems to favour a strategy of enhancing the efficacy of autophagy by preventing or reversing the impairments of the specific processes that are disrupted. Therefore, it is essential to understand the underlying causes of the autophagy defect in different neurodegenerative diseases to explore possible therapeutic approaches. This review will focus on the role of autophagy during stress and ageing, consequences that are linked to its activation and caveats in modulating this pathway as a treatment

Insight into partial agonism by observing multiple equilibria for ligand-bound and Gs-mimetic nanobody-bound β1-adrenergic receptor.

A complex conformational energy landscape determines G-protein-coupled receptor (GPCR) signalling via intracellular binding partners (IBPs), e.g., Gs and β-arrestin. Using 13C methyl methionine NMR for the β1-adrenergic receptor, we identify ligand efficacy-dependent equilibria between an inactive and pre-active state and, in complex with Gs-mimetic nanobody, between more and less active ternary complexes. Formation of a basal activity complex through ligand-free nanobody-receptor interaction reveals structural differences on the cytoplasmic receptor side compared to the full agonist-bound nanobody-coupled form, suggesting that ligand-induced variations in G-protein interaction underpin partial agonism. Significant differences in receptor dynamics are observed ranging from rigid nanobody-coupled states to extensive μs-to-ms timescale dynamics when bound to a full agonist. We suggest that the mobility of the full agonist-bound form primes the GPCR to couple to IBPs. On formation of the ternary complex, ligand efficacy determines the quality of the interaction between the rigidified receptor and an IBP and consequently the signalling level

Effectiveness of Systematic Echocardiographic Screening for Rheumatic Heart Disease in Nepalese Schoolchildren: A Cluster Randomized Clinical Trial.

Importance Echocardiographic screening allows for early detection of subclinical stages of rheumatic heart disease among children in endemic regions. Objective To investigate the effectiveness of systematic echocardiographic screening in combination with secondary antibiotic prophylaxis on the prevalence of rheumatic heart disease. Design, Setting, and Participants This cluster randomized clinical trial included students 9 to 16 years of age attending public and private schools in urban and rural areas of the Sunsari district in Nepal that had been randomly selected on November 17, 2012. Echocardiographic follow-up was performed between January 7, 2016, and January 3, 2019. Interventions In the experimental group, children underwent systematic echocardiographic screening followed by secondary antibiotic prophylaxis in case they had echocardiographic evidence of latent rheumatic heart disease. In the control group, children underwent no echocardiographic screening. Main Outcomes and Measures Prevalence of the composite of definite or borderline rheumatic heart disease according to the World Heart Federation criteria in experimental and control schools as assessed 4 years after intervention. Results A total of 35 schools were randomized to the experimental group (n = 19) or the control group (n = 16). After a median of 4.3 years (interquartile range [IQR], 4.0-4.5 years), 17 of 19 schools in the experimental group (2648 children; median age at follow-up, 12.1 years; IQR, 10.3-12.5 years; 1308 [49.4%] male) and 15 of 16 schools in the control group (1325 children; median age at follow-up, 10.6 years; IQR, 10.0-12.5 years; 682 [51.5%] male) underwent echocardiographic follow-up. The prevalence of definite or borderline rheumatic heart disease was 10.8 per 1000 children (95% CI, 4.7-24.7) in the control group and 3.8 per 1000 children (95% CI, 1.5-9.8) in the experimental group (odds ratio, 0.34; 95% CI, 0.11-1.07; P = .06). The prevalence in the experimental group at baseline had been 12.9 per 1000 children (95% CI, 9.2-18.1). In the experimental group, the odds ratio of definite or borderline rheumatic heart disease at follow-up vs baseline was 0.29 (95% CI, 0.13-0.65; P = .008). Conclusions and Relevance School-based echocardiographic screening in combination with secondary antibiotic prophylaxis in children with evidence of latent rheumatic heart disease may be an effective strategy to reduce the prevalence of definite or borderline rheumatic heart disease in endemic regions. Trial Registration ClinicalTrials.gov Identifier: NCT01550068

A cluster randomized controlled trial of an electronic decision-support system to enhance antenatal care services in pregnancy at primary healthcare level in Telangana, India: trial protocol

BACKGROUND: India contributes 15% of the total global maternal mortality burden. An increasing proportion of these deaths are due to Pregnancy Induced Hypertension (PIH), Gestational Diabetes Mellitus (GDM), and anaemia. This study aims to evaluate the effectiveness of a tablet-based electronic decision-support system (EDSS) to enhance routine antenatal care (ANC) and improve the screening and management of PIH, GDM, and anaemia in pregnancy in primary healthcare facilities of Telangana, India. The EDSS will work at two levels of primary health facilities and is customized for three cadres of healthcare providers - Auxiliary Nurse Midwifes (ANMs), staff nurses, and physicians (Medical Officers). METHODS: This will be a cluster randomized controlled trial involving 66 clusters with a total of 1320 women in both the intervention and control arms. Each cluster will include three health facilities-one Primary Health Centre (PHC) and two linked sub-centers (SC). In the facilities under the intervention arm, ANMs, staff nurses, and Medical Officers will use the EDSS while providing ANC for all pregnant women. Facilities in the control arm will continue to provide ANC services using the existing standard of care in Telangana. The primary outcome is ANC quality, measured as provision of a composite of four selected ANC components (measurement of blood pressure, blood glucose, hemoglobin levels, and conducting a urinary dipstick test) by the healthcare providers per visit, observed over two visits. Trained field research staff will collect outcome data via an observation checklist. DISCUSSION: To our knowledge, this is the first trial in India to evaluate an EDSS, targeted to enhance the quality of ANC and improve the screening and management of PIH, GDM, and anaemia, for multiple levels of health facilities and several cadres of healthcare providers. If effective, insights from the trial on the feasibility and cost of implementing the EDSS can inform potential national scale-up. Lessons learned from this trial will also inform recommendations for designing and upscaling similar mHealth interventions in other low and middle-income countries

Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing