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"Agrawal, Abha"
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Safety of Health IT
This practical text provides an overview of the adverse consequences of health information technology (HIT) and its impact on patient safety.Specific cases of errors and risks related to various types of HIT are featured along with best practices for patient safety, workflows and organizational standards.
eBook
Patient Safety
Despite the evolution and growing awareness of patient safety, many medical professionals are not a part of this important conversation. Clinicians often believe they are too busy taking care of patients to adopt and implement patient safety initiatives and that acknowledging medical errors is an affront to their skills.
eBook
First Do No Harm: An Overview of HIT and Patient Safety
Growing concerns about the cost, efficiency, and safety of our health care system have turned national attention on health care information technologies (HIT) such as electronic health records (EHRs) as important foundational solutions to enable the transformation of health care delivery. However, a growing number of research and review articles are raising concerns that poor implementation, workflow integration or design of EHR systems can paradoxically facilitate medication errors, increase mortality, lead to physician dissatisfaction, and adversely impact physician–patient relationship. Through the lens of a variety of case studies, this reference book illustrates that HIT/EHR usage is not without risks and provides practical, clinically acceptable risk mitigation strategies.
Book Chapter
Secondary metabolites responses of plants exposed to ozone: an update
Tropospheric ozone (O
3
) is a secondary pollutant that causes oxidative stress in plants due to the generation of excess reactive oxygen species (ROS). Phenylpropanoid metabolism is induced as a usual response to stress in plants, and induction of key enzyme activities and accumulation of secondary metabolites occur, upon O
3
exposure to provide resistance or tolerance. The phenylpropanoid, isoprenoid, and alkaloid pathways are the major secondary metabolic pathways from which plant defense metabolites emerge. Chronic exposure to O
3
significantly accelerates the direction of carbon flows toward secondary metabolic pathways, resulting in a resource shift in favor of the synthesis of secondary products. Furthermore, since different cellular compartments have different levels of ROS sensitivity and metabolite sets, intracellular compartmentation of secondary antioxidative metabolites may play a role in O
3
-induced ROS detoxification. Plants’ responses to resource partitioning often result in a trade-off between growth and defense under O
3
stress. These metabolic adjustments help the plants to cope with the stress as well as for achieving new homeostasis. In this review, we discuss secondary metabolic pathways in response to O
3
in plant species including crops, trees, and medicinal plants; and how the presence of this stressor affects their role as ROS scavengers and structural defense. Furthermore, we discussed how O
3
affects key physiological traits in plants, foliar chemistry, and volatile emission, which affects plant–plant competition (allelopathy), and plant–insect interactions, along with an emphasis on soil dynamics, which affect the composition of soil communities via changing root exudation, litter decomposition, and other related processes.
Journal Article
Assessment of ozone toxicity among 14 Indian wheat cultivars under field conditions: growth and productivity
Tropospheric ozone (O
3
) is a well-known threat to global agricultural production. Wheat (
Triticum aestivum
L.) is the second most important staple crop in India, although little is known about intra-specific variability of Indian wheat cultivars in terms of their sensitivity against O
3
. In this study, 14 wheat cultivars widely grown in India were exposed to 30 ppb elevated O
3
above ambient level using open top chambers to evaluate their response against O
3
stress. Different growth and physiological parameters, foliar injury and grain yield were evaluated to assess the sensitivity of cultivars and classified them on the basis of their cumulative stress response index (CSRI). Due to elevated O
3
, growth parameters, plant biomass, and photosynthetic rates were negatively affected, whereas variable reductions in yield were observed among the test cultivars. Based on CSRI values, HD 2987, DBW 50, DBW 77, and PBW 550 were classified as O
3
sensitive; HD 2967, NIAW 34, HD 3059, PBW 502, HUW 213, and HUW 251 as intermediately sensitive, while HUW12, KUNDAN, HUW 55, and KHARCHIYA 65 were found to be O
3
-tolerant cultivars. Cultivars released after year 2000 were found to be more sensitive compared to earlier released cultivars. Path analysis approach showed that leaf area, plant biomass, stomatal conductance, net assimilation rate, and absolute growth rate were the most important variables influencing yield under O
3
stress. Findings of the current study highlight the importance of assessing differential sensitivity and tolerance of wheat cultivars and response of different traits in developing resistance against elevated O
3
.
Journal Article
Assessment of Ozone Sensitivity in Three Wheat Cultivars Using Ethylenediurea
Three wheat (Triticum aestivum L.) cultivars [HD 2987 (ozone (O3) sensitive), PBW 502 (intermediately sensitive) and Kharchiya 65 (O3 tolerant)] with known sensitivity to O3 were re-evaluated using ethylenediurea (EDU; 400 ppm) to ascertain the use of EDU in determiningO3 sensitivity under highly O3-polluted tropical environments. EDU treatment helped in improving the growth, biomass, photosynthetic pigments and the antioxidative defense system of all the wheat cultivars. Under EDU treatment, PBW 502 retained more biomass, while HD 2987 showed better performance and ultimately the greatest increment in yield. Cultivar Kharchiya 65 also showed a positive response to EDU as manifested with an increase in pigment contents, total biomass and enzymatic antioxidants; however, this increment was comparatively lower compared to the other two cultivars. The results indicated that EDU did not have many physiological effects on cultivars but helped in counteracting O3 primarily by scavenging reactive oxygen species and enhancing the antioxidative defense system where superoxide dismutase emerged as the major responsive biochemical parameter against ambient O3. The observed results clearly indicated that differential O3 sensitivity in three wheat cultivars established by the previous study is in accordance with the present study using EDU as a sensitivity tool, which is an easy and efficient technology in comparison to chamber and Free-Air Carbon dioxide Enrichment (FACE) experiments although its mechanistic understanding needs to be further validated.
Journal Article
Tropospheric ozone pollution in India: effects on crop yield and product quality
Ozone (O
3
) in troposphere is the most critical secondary air pollutant, and being phytotoxic causes substantial losses to agricultural productivity. Its increasing concentration in India particularly in Indo-Gangetic plains is an issue of major concern as it is posing a threat to agriculture. In view of the issue of rising surface level of O
3
in India, the aim of this compilation is to present the past and the prevailing concentrations of O
3
and its important precursor (oxides of nitrogen) over the Indian region. The resulting magnitude of reductions in crop productivity as well as alteration in the quality of the product attributable to tropospheric O
3
has also been taken up. Studies in relation to yield measurements have been conducted predominantly in open top chambers (OTCs) and also assessed by using antiozonant ethylene diurea (EDU). There is a substantial spatial difference in O
3
distribution at different places displaying variable O
3
concentrations due to seasonal and geographical variations. This review further recognizes the major information lacuna and also highlights future perspectives to get the grips with rising trend of ground level O
3
pollution and also to formulate the policies to check the emissions of O
3
precursors in India.
Journal Article
Assessment of growth and yield losses in two Zea mays L. cultivars (quality protein maize and nonquality protein maize) under projected levels of ozone
Rapid industrialization and economic developments have increased the tropospheric ozone (O₃) budget since preindustrial times, and presently, it is supposed to be a major threat to crop productivity. Maize (Zea mays L.), a C4 plant is the third most important staple crop at global level with a great deal of economic importance. The present study was conducted to evaluate the performance of two maize cultivars [HQPM1: quality protein maize (QPM)] and [DHM117: nonquality protein maize (NQPM)] to variable O₃ doses. Experimental setup included filtered chambers, nonfiltered chambers (NFC), and two elevated doses of O₃ viz. NFC+15 ppb O₃ (NFC+15) and NFC+30 ppb O₃ (NFC+30). During initial growth period, both QPM and NQPM plants showed hormetic effect that is beneficial due to exposure of low doses of a toxicant (NFC and NFC+15 ppb O₃), but at later stages, growth attributes were negatively affected by O₃. Growth indices showed the variable pattern of photosynthate translocation under O₃ stress. Foliar injury in the form of interveinal chlorosis and reddening of leaves due to increased production of anthocyanin pigments was observed at higher concentrations of O₃. One-dimensional gel electrophoresis of leaves taken from NFC+30 showed reductions of major photosynthetic proteins, and differential response was observed between the two test cultivars. Decline in the number of male flowers at elevated O₃ doses suggested damaging effect of O₃ on reproductive structures which might be a cause of productivity losses. Variable carbon allocation pattern particularly to husk leaves, foliar injury, and damage of photosynthetic proteins led to significant reductions in economic yield at higher O₃ doses. PCA showed that both the cultivars responded more or less similarly to O₃ stress in their respective groupings of growth and yield parameters, but magnitude of their response was variable. It is further supported by difference in the significance of correlations between variables of yield and AOT40. Cultivar response reflects that QPM performed better than NQPM against elevated O₃.
Journal Article