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Background/Aim: Childhood anaemia continues to persist as a prominent nutritional disease and a public health challenge in India despite several initiatives by the Government of India. This study aimed to identify predictors and regional disparities for targeted interventions. Methods: This study utilised data from a nationally representative cross-sectional survey from the fifth round of the National Family Health Survey (NFHS-5), encompassing 177,695 children aged 6-59 months across 707 districts and 36 states and union territories of India. It employed multivariate logistic regression and spatial analysis at district levels to examine socio-demographic predictors and spatial patterns of childhood anaemia in the country. Result: Multivariate logistic results revealed, women aged 15-19 were 2.43 times more likely to have an anaemic child compared to those aged 35-49 and uneducated mothers had a 29 % higher likelihood of having an anaemic child. There was positive spatial autocorrelation (Moran's I value = 0.579) at the district level in India, with 108 identified hotspots in regions including Jammu and Kashmir, Ladakh, Gujarat, Maharashtra, Telangana, Uttar Pradesh, Rajasthan, Jharkhand, Chhattisgarh and Bihar. The spatial error model (SEM) indicated that mother's anaemia (0.53) and maternal education (0.23) were key predictors of child anaemia in India. Conclusion: The study findings provide valuable understanding regarding the socio-demographic predictors associated with childhood anaemia such as adolescent motherhood, low education, lack of media exposure, higher birth order and rural residence. Also, the spatial study provides the spatial heterogeneity of childhood anaemia at the district level and advocates more attention toward hotspot regions in the country.

The calcium-sensing receptor (CaSR), a cell-surface sensor for Ca.sup.2+, is the master regulator of calcium homeostasis in humans and is the target of calcimimetic drugs for the treatment of parathyroid disorders.sup.1. CaSR is a family C G-protein-coupled receptor.sup.2 that functions as an obligate homodimer, with each protomer composed of a Ca.sup.2+-binding extracellular domain and a seven-transmembrane-helix domain (7TM) that activates heterotrimeric G proteins. Here we present cryo-electron microscopy structures of near-full-length human CaSR in inactive or active states bound to Ca.sup.2+ and various calcilytic or calcimimetic drug molecules. We show that, upon activation, the CaSR homodimer adopts an asymmetric 7TM configuration that primes one protomer for G-protein coupling. This asymmetry is stabilized by 7TM-targeting calcimimetic drugs adopting distinctly different poses in the two protomers, whereas the binding of a calcilytic drug locks CaSR 7TMs in an inactive symmetric configuration. These results provide a detailed structural framework for CaSR activation and the rational design of therapeutics targeting this receptor. Cryo-EM structures of human calcium-sensing receptor reveal intrinsic asymmetry in the receptor homodimer upon activation that is stabilized by calcimimetic drugs adopting distinct poses in the two protomers, priming one protomer for G-protein coupling., Author(s): Yang Gao [sup.1] [sup.2] , Michael J. Robertson [sup.1] [sup.2] , Sabrina N. Rahman [sup.4] , Alpay B. Seven [sup.1] [sup.2] , Chensong Zhang [sup.1] [sup.2] , Justin G. [...]

The calcium-sensing receptor (CaSR) is a family C G-protein-coupled receptor1 (GPCR) that has a central role in regulating systemic calcium homeostasis2,3. Here we use cryo-electron microscopy and functional assays to investigate the activation of human CaSR embedded in lipid nanodiscs and its coupling to functional Gi versus Gq proteins in the presence and absence of the calcimimetic drug cinacalcet. High-resolution structures show that both Gi and Gq drive additional conformational changes in the activated CaSR dimer to stabilize a more extensive asymmetric interface of the seven-transmembrane domain (7TM) that involves key protein–lipid interactions. Selective Gi and Gq coupling by the receptor is achieved through substantial rearrangements of intracellular loop 2 and the C terminus, which contribute differentially towards the binding of the two G-protein subtypes, resulting in distinct CaSR–G-protein interfaces. The structures also reveal that natural polyamines target multiple sites on CaSR to enhance receptor activation by zipping negatively charged regions between two protomers. Furthermore, we find that the amino acid l-tryptophan, a well-known ligand of CaSR extracellular domains, occupies the 7TM bundle of the G-protein-coupled protomer at the same location as cinacalcet and other allosteric modulators. Together, these results provide a framework for G-protein activation and selectivity by CaSR, as well as its allosteric modulation by endogenous and exogenous ligands. Cryo-electron microscopy structures of the human calcium-sensing receptor in complex with Gi and Gq proteins reveal how this receptor activates distinct G protein subtypes and how its function is modulated by a variety of ligands. [ABSTRACT FROM AUTHOR]

When physicians admit patients to a hospital, their decisions about where--and to whose professional stewardship and services--those patients belong are influenced by federal policies, of which many clinicians are not aware. The distinction between observation and admission has clinical and ethical implications for patients and practices. The evolution of "observation status" from a clinical tool to a catchall of vague and imprecise meaning has been driven by changes to physician payment and compensation structures, particularly Current Procedural Terminology codes and Centers for Medicare and Medicaid Services regulations, and its current value to clinicians and patients is questionable. This article contextualizes clinicians' admission and observation practices and considers how metrics influence patient costs and how clinicians and organizations are compensated. [ABSTRACT FROM AUTHOR]

With destinations steadily 'opening back up for business' (while COVID-19 cases are still high in many areas), there is an increasing need to consider residents. Integrating the cognitive appraisal theory and the affect theory of exchange, this work tests a structural model examining the degree to which residents' perceptions of COVID-19 precautionary measures explain emotions directed toward visitors, and ultimately their willingness to engage in shared behaviors with tourists. Data were collected from 530 residents in 25 U.S. counties with the highest percentages of historical COVID-19 cases per population. A total of 10 of the 12 tested hypotheses were significant, contributing to 60% and 85% of the variance explained in contending and accommodating emotions, and 53% and 50% of the variance explained in engaging in less intimate–distal and more intimate–proximal behaviors with tourists. The implications highlight the complementary use of the two frameworks in explaining residents' preference for engagement in less intimate–distal interactions with tourists. [ABSTRACT FROM AUTHOR]

The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. A cross-sectional survey was conducted in parents 6–18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series. [ABSTRACT FROM AUTHOR]

This study reports on performance enhancement of a Cu2ZnSnS4 solar cell introducing Sb2S3 as hole transport layer (HTL) along WS2 as buffer layer. We have investigated photovoltaic (PV) characteristics by utilizing SCAPS‐1D. A comparative analysis on PV performances between conventional CZTS/CdS and proposed Ni/Sb2S3/CZTS/WS2/FTO/Al solar cells is presented. It is revealed that "spike like" band structure at the CZTS/WS2 interface having smaller conduction band offset makes it potential alternative to commonly used CdS buffer. This report also evaluates that the Sb2S3 as an HTL inserted at the rear of CZTS enhances performances by reducing carrier recombination at back interface with appropriate band alignment. The impacts of thickness, carrier concentration of different layers, and bulk defect density in CZTS as well as the interface defects on cell outputs are analyzed. The influences of temperature, work function, and cell resistances are also examined. Optimum absorber thickness of 1.0 μm along doping density of 1017 cm−3 is selected. A maximum efficiency of 30.63% is achieved for the optimized CZTS cell. Therefore, these results suggest that Sb2S3 as HTL and WS2 as buffer layer can be employed effectively to develop highly efficient and low‐cost CZTS solar cells. [ABSTRACT FROM AUTHOR]

The present work investigates a tin-based highly efficient perovskite solar cell (PSC) by a solar cell capacitance simulator in one dimension. Molybdenum disulfide is introduced as hole transport layer in the proposed solar cell device structure. The photovoltaic performances of the proposed solar cell are investigated by varying thickness, doping concentration, and bulk defect density of various layers. Furthermore, the operating temperature and the series and shunt resistances are analyzed systematically. A higher conversion efficiency of 25.99% is obtained at the absorber thickness of 2000 nm. The optimum doping density of 1017 cm−3 is estimated for the absorber, electron transport layer (ETL), and hole transport layer (HTL), respectively. The optimum thicknesses of 50 nm, 1000 nm, and 60 nm are also found for the titanium dioxide as ETL, methylammonium tin triiodide (CH3NH3SnI3) as absorber layer, and molybdenum disulfide as HTL, respectively. The efficiency of the proposed lead-free CH3NH3SnI3-based solar cell with the alternative molybdenum disulfide HTL is calculated to be 24.65% with open-circuit voltage of 0.89 V, short-circuit current density of 34.04 mA/cm2, and fill-factor of 81.46% for the optimum parameters of all layers. These findings would contribute to fabricate low-cost, non-toxic, stable, and durable lead-free PSCs for the next generation. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a persistent disease in Bangladesh, which reportedly has a strong proportion of 7.1 million diabetics over 60 years old. Limited knowledge is a significant variable which affects and mainly preventsthe development and progression of diabetes. In order to determine the awareness of Type 2 diabetes among Geriatric patients in selected Dhaka hospitals, this cross-sectional clinical study was performed between May and August 2018. The research was carried out among 450 diabetic type 2 patients >60 years of age from three urban and suburban Dhaka hospitals. Data is obtained by standardized questionnaires faceto-face interviews. The average age was 64.86 ± 4.65 years for the respondents. 56 percent of the research participants were guys. With 34.2% of respondents who did not attend school and just 13.8% of graduates, education was low. Much of the respondents (63.56 percent) referred to diabetes. The awareness level of respondents with signs (80.7%), risk factors (84.4%), avoidance (84%), and management (71.6%) was low. Just 8.7 percent heard the risks of diabetes. The overall awareness score for the participants was recorded as fair (18.9%), decent (30.7%) and bad (50.4%). The awareness score was closely linked to schooling and diabetes period (p<0.01). The research indicated a lack of information among respondents. Geriatric diabetes patients with more diabetes treatment needs. It may also be argued that repeated enhancement and inspiration in combination with diabetes health education will contribute to a positive awareness improvement. [ABSTRACT FROM AUTHOR]