Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis

<div><h3>Background</h3><p>This paper examines if, when controlling for biophysical and geographical variables (including rainfall, productivity of agricultural lands, topography/temperature, and market access through road networks), socioeconomic and health care indicators help to explain variations in the under-five mortality rate across districts from nine high focus states in India. The literature on this subject is inconclusive because the survey data, upon which most studies of child mortality rely, rarely include variables that measure these factors. This paper introduces these variables into an analysis of 284 districts from nine high focus states in India.</p> <h3>Methodology/Principal Findings</h3><p>Information on the mortality indicator was accessed from the recently conducted Annual Health Survey of 2011 and other socioeconomic and geographic variables from Census 2011, District Level Household and Facility Survey (2007–08), Department of Economics and Statistics Divisions of the concerned states. Displaying high spatial dependence (spatial autocorrelation) in the mortality indicator (outcome variable) and its possible predictors used in the analysis, the paper uses the Spatial-Error Model in an effort to negate or reduce the spatial dependence in model parameters. The results evince that the coverage gap index (a mixed indicator of district wise coverage of reproductive and child health services), female literacy, urbanization, economic status, the number of newborn care provided in Primary Health Centers in the district transpired as significant correlates of under-five mortality in the nine high focus states in India. The study identifies three clusters with high under-five mortality rate including 30 districts, and advocates urgent attention.</p> <h3>Conclusion</h3><p>Even after controlling the possible biophysical and geographical variables, the study reveals that the health program initiatives have a major role to play in reducing under-five mortality rate in the high focus states in India.</p> </div

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Role of Echocardiography in Evaluation of Women with Chest Pain

© Springer-Verlag London 2013. All rights are reserved. This chapter reviews the role of echocardiography in evaluation of women with chest pain. Stress echocardiography is a well-established and diagnostically reliable modality for assessment of women with chest pain and suspected myocardial ischemia due to epicardial coronary artery disease. The technique is particularly suitable in women because of the lack of radiation and applicability in individuals who are or are not able to exercise. The chapter addresses the difficult issue of chest pain in women with angiographically normal coronary arteries, including prognostic role of stress echocardiography in these women, and newer echocardiographic techniques for assessment of coronary flow reserve and detection of microvascular disease. The importance of coronary flow reserve abnormalities in women with chest pain is examined. The chapter concludes with a discussion of the role of transthoracic echocardiography in assessment of two other important cardiac causes of chest pain in women with angiographically normal coronary arteries - hypertrophic cardiomyopathy and stress-induced cardiomyopathy. The typical echocardiographic features of both types of cardiomyopathies are reviewed. Also, the role of coronary flow reserve and myocardial contrast in clarifying the causes of ischemia in these entities is examined