Explore the vast range of titles available.

Using the consumption expenditure data, National Sample Survey, 2009–2010, this paper test the hypothesis that the monthly per capita household health spending of elderly households is significantly higher than non-elderly households in India. The households are classified into three mutually exclusive groups; households with only elderly members (elderly households), households with elderly and non-elderly members and households without any elderly member. The health spending include the institutional (hospitalization) and non-institutional health expenditure of the households, standardized for 30 days. Descriptive statistics and a two part model are used to understand the differentials in health expenditures across households. Results indicate that the monthly per capita health spending increases with economic status, occupation, age and educational attainment of the head of the household. The monthly per capita health spending of elderly households is 3.8 times higher than that of non-elderly households. While the health spending accounts 13 % of total consumption expenditure for elderly households, it was 7 % among households with elderly and non-elderly members, and 5 % among non-elderly households. Controlling for socio-economic and demographic correlates, the per-capita household health spending among elderly households and among household with elderly and non-elderly members was significantly higher than non-elderly households. The health expenditure is catastrophic for poorer households, casual labourer and households with elderly members. Based on the finding we suggest to increased access to health insurance and public spending on geriatric care to reduce the out-of-pocket expenditure on health care in India.

Using three quinquennial rounds of consumption expenditure data over two decades (1993–2012), this paper estimates the extent of money metric poverty and inequality in regions of India. Regions are made comparable, and the poverty head count ratio and the poverty gap ratio for 81 regions are derived using the state specific poverty lines as recommended by the Planning Commission of India. The gini index, rich–poor ratio and regression analyses are used to understand the extent of economic inequality in regions of India. Results indicate that though the extent of poverty has declined, economic inequality has increased in regions of India. During 1993–2012, the poverty head count ratio had decreased in 70 regions, increased in seven regions and remained similar in four regions of India. The southern regions of Odisha and southern regions of Chhattisgarh are reeling under high persistent poverty. The spread in poverty head count ratio among regions has increased from 0.38 in 1993–1994 to 0.64 in 2011–2012 confirming divergence in regional poverty in India. The pattern is similar with respect to poverty gap ratio. Regions of Tripura and Sikkim had highest improvements in poverty level. On contrast to poverty estimates, the gini index has decreased in 20 regions and increased in 61 regions. Likewise, 57 regions have recorded increase in rich–poor ratio. The rich–poor ratio was higher in developed regions and lower in less developed regions. Based on these findings, we suggest that regions with persistently high poverty be accorded priority in poverty alleviation program and explore the factors leading to increasing economic inequality.

ObjectivesTo examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India.DesignData for the present study are taken from the Annual Health Survey (AHS), 2010–2013 and Census of India, 2011.SettingsThis study used secondary data from states having higher mortality and fertility rates, termed as high focus states in India.ParticipantsDistrict-level information regarding children aged 12–23 months and ever married women aged 15–49 years has been extracted from the AHS (2010–2013), and household amenities, female literacy and main workforce information has been obtained from the Census of India 2011.Measures2 summary indexes were calculated first for maternal and child health services and another for socioeconomic and development status, using data from AHS and Census. Cronbach's α was used to assess the internal consistency of the items used in the index.ResultsThe result shows that the coverage gap is highest in Uttar Pradesh (37%) and lowest in Madhya Pradesh (21%). Converge gap and socioeconomic development are negatively correlated (r=−0.49, p=0.01). The average coverage gap was highest in the lowest quintile of socioeconomic development. There was an absolute change of 1.5% per year in coverage gap during 2009–2013. In regression analysis, the coefficient of determination was 0.24, β=−30.05, p=0.01 for a negative relationship between socioeconomic development and coverage gap.ConclusionsThere is a significant disparity in the usage of maternal and child healthcare services in the districts of India. Resource-rich people (urban residents and richest quintile) are way ahead of marginalised people (rural residents and poorest quintile) in the usage of healthcare services.

This paper aims to examine the association of female education, under-five mortality, and poverty in fertility reduction in the districts of India. Data from the census of India and large-scale population-based surveys are used. Difference-in-difference panel models are used to account for both initial conditions and contemporaneous changes in fertility reduction. While one-third of the districts have reached below replacement level of fertility, under-five mortality and poverty level have reduced by half from the initial level and the female literacy level has almost doubled, suggesting a remarkable degree of convergence across all distal determinants but only limited evidence of convergence for fertility. The single largest predictor of fertility reductions in the districts of India was initial TFR, followed by increase in female literacy, the initial female literacy level and reduction in under-five mortality. The effect of initial level of poverty on fertility reduction was 0.13, while that of reduction in poverty was -0.05.

Aim This paper examines the pattern, growth and determinants of household health spending in India and compares the growth of per capita household health spending and per capita consumption expenditure over the last two decades. Subject and methods The unit data of various rounds of the National Sample Survey (consumption expenditure surveys 1993–1994, 2004–2005 and 2011–2012 and morbidity and health care surveys 1995–1996 and 2004) along with data from other secondary sources are used in the analyses. The patterns and growth of health spending are analyzed by demographic, social and economic attributes and economic well-being is measured using per capita consumption expenditure. Household health spending is subdivided into age structure, population growth, real cost of medical care and increased hospitalization. Descriptive statistics, fixed effect models and simple decomposition methods are used in the analyses. Results Results suggest that during 1993–2012, the annual growth rate of real per capita household health spending was twice (6.14 %) the real per capita consumption expenditure (2.60 %). On average, per capita household health spending among the richest consumption quintile was at least eight times higher than that of the poorest consumption quintile, linking household health spending to ability to pay. Household health spending was income inelastic. Though medicine accounts for a larger share of household health spending, household spending on medical tests is growing fast. We found a strong and positive gradient of age on per capita household health spending after controlling for income and other confounders. During 1995–2004, the age structure, hospitalization and real cost of hospitalization accounted for a 14, 42 and 26 % increase in the cost of hospitalization respectively. Conclusion Household health spending is growing faster than the consumption expenditure (economic well being) of household and changing age structure is significantly affecting health spending in India. Increased public spending on health, upgrading the public health system and increasing access to health insurance can reduce the household health spending in India.

In the era of rapid climate change, abiotic stresses are the primary cause for yield gap in major agricultural crops. Among them, salinity is considered a calamitous stress due to its global distribution and consequences. Salinity affects plant processes and growth by imposing osmotic stress and destroys ionic and redox signaling. It also affects phytohormone homeostasis, which leads to oxidative stress and eventually imbalances metabolic activity. In this situation, signaling compound crosstalk such as gasotransmitters [nitric oxide (NO), hydrogen sulfide (H 2 S), hydrogen peroxide (H 2 O 2 ), calcium (Ca), reactive oxygen species (ROS)] and plant growth regulators (auxin, ethylene, abscisic acid, and salicylic acid) have a decisive role in regulating plant stress signaling and administer unfavorable circumstances including salinity stress. Moreover, recent significant progress in omics techniques (transcriptomics, genomics, proteomics, and metabolomics) have helped to reinforce the deep understanding of molecular insight in multiple stress tolerance. Currently, there is very little information on gasotransmitters and plant growth regulator crosstalk and inadequacy of information regarding the integration of multi-omics technology during salinity stress. Therefore, there is an urgent need to understand the crucial cell signaling crosstalk mechanisms and integrative multi-omics techniques to provide a more direct approach for salinity stress tolerance. To address the above-mentioned words, this review covers the common mechanisms of signaling compounds and role of different signaling crosstalk under salinity stress tolerance. Thereafter, we mention the integration of different omics technology and compile recent information with respect to salinity stress tolerance.

ABSTRACT Learning Objective: Hemodynamic monitoring during in-hospital transport of intubated patients is vital; however, no prospective randomized trials have evaluated the hemodynamic consequences of hand versus machine ventilation during transport among pediatric patients' post-cardiac surgery. The authors hypothesized that manual ventilation after pediatric cardiac surgery would alter hemodynamic and arterial blood gas (ABG) parameters during transport compared to mechanical ventilation. Design: A prospective randomized trial. Setting: Tertiary cardiac care hospital. Participants: Pediatric cardiac surgery patients. Materials and Methods: One hundred intubated pediatric patients were randomized to hand or machine ventilation immediately post-cardiac surgery during transport from the operating room to the pediatric post-operative intensive care unit (PICU). Hemodynamic variables, including end-tidal CO2 (ETCO2), oxygen saturation, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), peak airway pressure (Ppeak), and mean airway pressure (Pmean), were measured at origin, during transport, and at the destination. ABG was measured before and upon arrival in the PICU, and adverse events were recorded. The Chi-square test and independent t-test were used for comparison of categorical and continuous parameters, respectively. Results and Discussion: The mean transport time was comparable between hand-ventilated (5.77 ± 1.46 min) and machine-ventilated (5.96 ± 1.19 min) groups (P = 0.47). ETCO2 consistently dropped during transport and after shifting in the hand-ventilated group, with significantly higher ETCO2 excursion than in machine-ventilated patients (P < 0.05). SBP and DBP significantly decreased during transport (at 5 and 6 min intervals) and after shifting in hand-ventilated patients than in the other group (P < 0.05). Additionally, after shifting, a significant increase in Ppeak (P < 0.001), Pmean (P < 0.001), and pH (P < 0.001), and a decrease in pCO2 (P = 0.0072) was observed in hand-ventilated patients than machine-ventilated patients. No adverse event was noted during either mode of ventilation. Conclusion: Hand ventilation leads to more significant variation in ABG and hemodynamic parameters than machine ventilation in pediatric patients during transport post-cardiac surgery. Therefore, using a mechanical ventilator is the preferred method for transporting post-operative pediatric cardiac patients.

Major research interests on quantum key distribution (QKD) are primarily focused on increasing 1. Point-to-point transmission distance (1000 km). 2. Secure key rate (Mbps). 3. Security of quantum layer (device-independence). It is great to push the boundaries in these fronts but these isolated approaches are neither scalable nor cost-effective due to requirements of specialised hardware and different infrastructure. Current and future QKD network requires addressing different set of challenges apart from distance, key rate and quantum security. In this regard, we present ChaQra—a sub quantum network with core features as 1. Crypto agility (integration in the already deployed telecommunication fibres). 2. Software defined networking (SDN paradigm for routing different nodes). 3. reliability (addressing denial-of-service with hybrid quantum safe cryptography). 4. upgradability (modules upgradation based on scientific and technological advancements). 5. Beyond QKD (using QKD network for distributed computing, multi-party computation etc). Our results demonstrate a clear path to create and accelerate quantum secure Indian subcontinent under national quantum mission.

Rifampicin (R) and isoniazid (H) are key first-line anti-tuberculosis drugs. Failure to detect resistance to these two drugs early results in treatment failure and poor clinical outcomes. The study purpose was to validate the use of the GenoType MTBDRplus line probe assay (LPA) to detect resistance to R and H in Mycobacterium tuberculosis strains directly from smear-positive sputum samples in India. Smear positive sputum specimens from 320 patients were subjected to LPA and results compared against those from conventional Lowenstein Jensen (LJ) culture and drug susceptibility testing (C&DST). All specimens with discordant R DST results were subjected to either sequencing of the rpoB gene and/or repeat DST on liquid culture (MGIT 960) at a National Reference Laboratory. Significantly higher proportion of interpretable results were observed with LPA compared to LJ C&DST (94% vs. 80%, p-value <0.01). A total of 248 patients had both LJ and LPA DST results available; 232 (93.5%) had concordant R DST results. Among the 16 discordant R DST results, 13 (81%) were resolved in agreement with LPA results. Final LPA performance characteristics were sensitivity 96% (CI: 90%-98%), specificity 99% (CI: 95%-99%), positive predictive value 99% (CI: 95%-99%), and negative predictive value 95% (CI: 89%-98%). The median turnaround testing time, including specimen transportation time, on LPA was 11 days as compared with 89 days for LJ C&DST. LPA proved highly accurate in the rapid detection of R resistance. The reduction in time to diagnosis may potentially enable earlier commencement of the appropriate drug therapy, leading to some reduction of transmission of drug-resistant strains.

Recent developments in nanotechnology have revealed the significance of bimetallic nanoparticles for various applications. This study reveals the facile green synthesis of Ag-Co bimetallic nanoparticles using eugenol. A comparative analysis of Eugenol-loaded Ag-Co and unloaded Ag-Co bimetallic nanoparticle (BNPs) was done to investigate their antibacterial and antioxidant activity using flow cytometry. The biosynthesized Eugenol-loaded and unloaded BNPs were evaluated for antibacterial activity against  Escherichia coli . The antioxidant activity was analyzed by using a DPPH scavenging activity assay and flow cytometry. UV–Vis spectroscopic analysis of synthesized eugenol-loaded and unloaded BNPs showed absorbance at 257 nm and 240 nm, respectively. FTIR analysis showed the peak range in the 500–4000 cm- 1 corresponds to different functional groups. Zeta potential confirms the formation of stable and uniformly synthesized BNPs. EDX and SEM analysis confirm the elemental compositions and the size of the BNPs, respectively. Flow cytometric analysis revealed the live-dead parameters of  Escherichia coli , when exposed to different concentrations of Eugenol-loaded Ag-Co (Eu@Ag-Co) and Unloaded Ag-Co BNPs. In addition, comparative MIC and MBC values of eugenol-loaded and unloaded BNPs were obtained for  Escherichia coli. The Antioxidant activity revealed the comparative higher significant DPPH scavenging activity of Eu@Ag-Co. Moreover, the flow cytometric analysis confirmed the higher antibacterial efficacy of Eu@Ag-Co over unloaded Ag-Co BNPs by showing a higher percentage of dead cells. The study determined the enhanced antibacterial and antioxidant activity of nanoparticles by Eugenol loading and advocated it to be a better therapeutic approach. This study encourages the use of biosynthesized loaded-phytochemicals BNPs over unloaded BNPs. Graphical Abstract