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Appliance labels allow consumers to choose products based on their energy use. In most countries, the widely adopted comparative categorical labels give information on energy use in physical units such as kilowatt-hour. Studies on the impact of monetary cost information on labels have reported different results across appliances within studies, and for the same appliances across studies. Recent studies on refrigerators show that monetary information increases the probability of cost-effectiveness analysis and fosters choice of energy-efficient refrigerators but do not estimate the consumer willingness to pay for higher efficiency category. In a discrete choice experiment, we observe choices of a sample of households divided into groups based on whether they get operating cost information on hypothetical choices. We estimate a mixed logit model with correlated random parameters and estimate the magnitude and distribution of consumer willingness to pay for higher energy efficiency category. We find that energy cost information on labels facilitate comparison of refrigerators based on energy-efficiency and leads to a positive willingness to pay for higher levels of energy efficiency. It also increases the share of respondents having a positive willingness to pay for higher efficiency. We conclude that annual energy cost information on refrigerator labels can improve the effectiveness of labelling policy in India. Keywords: Energy efficiency, Appliance labelling, Willingness to pay, Energy cost information, Discrete choice model, 1. INTRODUCTION Research shows that energy-efficient technologies are cost-effective, yet they face multiple barriers in adoption (Ruderman et al., 1987; Sutherland, 1991), the phenomenon commonly referred to as the 'energy-efficiency [...]

Objective: The incidence of hard-to-heal wound infection, especially as a result of multidrug-resistant Gram-negative organisms, has increased in recent years. The reason for the increase is multifactorial and the ability of these pathogenic isolates to form biofilms is one of the important risk factors in wound infection. This study aimed to evaluate the risk factors associated with such cases. Method: This prospective analytical study, conducted over a period of two months, included pus or tissue samples from hospital inpatients with Gram-negative hard-to-heal wound infection. The samples were processed with conventional microbiological techniques. Patient demographic details and the presence of various risk factors were recorded. Biofilm production was detected by tissue culture plate method in the laboratory. The data were analysed using SPSS version 21 (IBM Ltd., US). Results: The experimental cohort comprised 200 patients. Klebsiella spp. was the most common identified organism, followed by Escherichia coli and Pseudomonas spp. Carbapenem resistance was observed in 106 (53%) strains. Almost 66% of the strains showed biofilm formation. On evaluation of associated risk factors, age (p=0.043), presence of biofilms (p=0.0001), diabetes (p=0.002), hypertension (p=0.02) and medical device use (p=0.008) had significant association, whereas sex, previous surgery and prior antibiotic use had no significant impact on the chronicity of the wound. Conclusion: In this study, chronicity of wounds was observed to be associated with multiple risk factors, especially the biofilm-forming ability of the strain. Biofilms are difficult to eradicate and additional measures, such as physical debridement, are important for resolving chronicity. Knowledge about specific risk factors would also allow clinicians a better understanding of the healing process and drive appropriate wound care interventions. Declaration of interest: A grant was received from the Indian Council of Medical Research (ICMR) for this work (grant ID: 2017-02686). The authors have no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Technology is widely promoted as a solution to greater independence and better health for the rapidly growing UK older population. If this is to be realised, we need to understand barriers and facilitators to uptake and investigate who wants this technology and who does not express an interest in use. This analysis is based on data from a population-based cohort study, the Cognitive Function and Ageing Study (CFAS)-II, which focused on brain health in older people and included questions about access to- and interest in- internet technologies. The factors affecting willingness to use technologies that support memory and ADL were identified using binary logistic regression analysis. 541 people aged 75 years and older from Cambridgeshire, Nottingham and Newcastle responded. Older adults were more willing to use technologies directed towards improving memory (65%) than towards ADL supportive technologies (38%). Regression analysis showed that an older age (OR = 0.64, 95% CI = 0.34–0.98), female gender (OR = 0.64, 95% CI = 0.42–0.99), no access to technology including laptops and tablets (OR = 0.48, 95% CI = 0.32–0.72), and self-reported physically less slowing down (but no objective health indicators) (OR = 0.57, 95% CI = 0.36–0.88) were strongly associated with UK older adults' lesser willingness to use memory assistive technologies while not having access to laptops and tablets (OR = 0.57, 95% CI = 0.39–0.84) was associated with willingness to use ADL supportive technologies. Older people, females and those with less access to technologies should be considered as target groups by healthcare providers, policymakers, and technology producers to promote technology and support healthy and independent ageing. [ABSTRACT FROM AUTHOR]

Introduction: It is unclear if serum procalcitonin (PCT) estimated at sepsis suspicion can help detect culture-positive sepsis in neonates. We evaluated the diagnostic performance of PCT in culture-positive sepsis in neonates. Methods: This was a prospective study (February 2016 to September 2020) conducted in four level-3 units in India. We enrolled neonates suspected of sepsis in the first 28 days of life. Neonates with birth weight <750 g, asphyxia, shock, and major malformations were excluded. Blood for PCT assay was drawn along with the blood culture at the time of suspicion of sepsis and before antibiotic initiation. The investigators labeled the neonates as having culture-positive sepsis or "no sepsis" based on the culture reports and clinical course. PCT assay was performed by electrochemiluminescence immunoassay, and the clinicians were masked to the PCT levels while assigning the label of sepsis. Primary outcomes were the sensitivity, specificity, and likelihood ratios to identify culture-positive sepsis. Results: The mean birth weight (SD) and median gestation (IQR) were 2,113 (727) g and 36 (32–38) weeks, respectively. Of the 1,204 neonates with eligible cultures, 155 (12.9%) had culture-positive sepsis. Most (79.4%) were culture-positive within 72 h of birth. The sensitivity, specificity, and positive and negative likelihood ratios at 2 ng/mL PCT threshold were 52.3% (95% confidence interval: 44.1–60.3), 64.5% (60.7–68.1), 1.47 (1.23–1.76), and 0.74 (0.62–0.88), respectively. Adding PCT to assessing neonates with 12.9% pretest probability of sepsis generated posttest probabilities of 18% and 10% for positive and negative test results, respectively. Conclusion: Serum PCT did not reliably identify culture-positive sepsis in neonates. [ABSTRACT FROM AUTHOR]

Aplastic anemia (AA) is a rare immunologically mediated bone marrow failure syndrome, characterized by progressive loss of hematopoietic stem cells resulting in peripheral pancytopenia. Elaborative investigation including molecular tests is required to exclude inherited bone marrow failure syndrome (IMBFS) as the treatment and prognosis vary dramatically between them. Haematopoietic stem cell transplant with a fully matched sibling donor (MSD-HSCT) is still the only curative treatment. Management of AA is a real-time challenge in India, because of the delay in the diagnosis, lack of proper supportive care, limited availability of the expertise centre, and the patient's affordability. Recently, results with intensified immunosuppressive therapy that includes anti-thymocyte globulin with cyclosporine-A (CsA) and eltrombopag, are enough encouraging to consider it as treatment of choice in patients lacking MSD or who are not fit for HSCT. However, limitations in resource constraints settings including the cost of therapy limit its full utilization. Relapse of the disease or evolution to myelodysplasia or paroxysmal nocturnal haemoglobinuria (PNH) in a proportion of patients is another challenge with immunosuppressants. The majority of the AA patients still receive CsA with or without androgens in India, mostly because of increased cost and limited availability of HSCT and ATG. The use of the unrelated or alternative donor is still upcoming in India, with unavailable data in terms of response and survival. Therefore, there is an utmost need for novel agents for the better management of AA having a balanced efficacy and toxicity profile to improve the survival and quality of life. [ABSTRACT FROM AUTHOR]

This paper offers a picture of disability based on census 2011, India. As per Census 2011 India, We examine the impact of demographic factors on attitudes towards students with disabilities versus non-disabled students in government and private Technical and non-technical educational institutions in India. Andrew Fisher's formula is used to determine the sample size for our investigation. Hypothesis testing has been done by using a t-test and chi-square test for comparison between the variables. Descriptive statistics are used to represent the graphical representation of the data set. This study will be helpful to know the mind-set of disabled v/s no- disabled students. At the end of the study, results were discussed with the help of graphs and tables by using Statistical Package for the Social Sciences (SPSS) and Microsoft excel. [ABSTRACT FROM AUTHOR]

Objectives: Providing safe drinking water is essential for maintaining healthcare quality. The presence of biofilms in the water supply protects the organism from the antimicrobial effects of disinfectants leading to the formation of the MDR pathogen pool. Therefore, this study was taken up to determine the prevalence of biofilm formation in the bacteria isolated from the water system of a tertiary health care setup and study the effect of disinfectants on biofilms. Methods: Thirty-four drinking water samples were collected in sterile glass stopper bottles and transported to the lab. Standard bacteriological procedures identified isolates. Biofilm detection was carried out by the tissue culture plate (TCP) method. The effect of disinfectant (sodium hypochlorite) at various concentrations (0, 0.25, 0.5, 1, 2, and 4 %) on biofilm-producing organism were studied for 30 minutes and analyzed. Results: The culture positivity was 76.4% (26/34). Twenty samples showed monomicrobial growth, while only six samples showed polymicrobial growth of organisms. The most common organism isolated was Pseudomonas aeruginosa. Biofilm production was seen more in polymicrobial organisms, 91.66 % (11/12). A high level of resistance to chlorine compounds was seen in biofilm-producing microorganisms, especially those that produced robust biofilms. Conclusion: Resistance of biofilms against high levels of chlorine has implications for the delivery of safe drinking water. Drug resistance was seen in these organisms, which can be transmitted from drinking water sources to humans. Therefore, it is recommended that biofilm production should be evaluated in drinking water samples regularly. [ABSTRACT FROM AUTHOR]

Introduction: Lung cancer is the most common cause of cancer mortality worldwide, principally because of its late diagnosis. Chronic inflammation plays a significant role in tumour growth and progression via increasing the levels of inflammatory markers in blood. Inflammatory markers are expected to be valuable prognostic biomarkers in cancer. Markers like Absolute Neutrophil Count (ANC), Absolute Lymphocyte Count (ALC), platelet count, Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) may aid in assessing prognosis of lung cancer. Aim: To study the inflammatory markers (ANC, ALC, Platelet count, NLR and PLR) in lung cancer and correlate these markers with cancer stage and histopathological type. Materials and Methods: A hospital-based cross-sectional study was conducted in lung cancer patients at Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India. Sixty patients with lung cancer and sixty controls were included. The clinical characteristics, ANC, ALC, platelet count, NLR and PLR of cases and controls were assessed and compared. Also, the comparison of these inflammatory markers with Tumor, Nodes and Metastases (TNM) staging and histopathological type of lung cancer were documented and results were interpreted. The data analysis was done with the use of Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, (Ver.) 26. Results: Mean age (years) of the case and control groups was 60.17 and 61.03, respectively. Distribution of gender in cases and controls was comparable. The major histology of lung cancer was Non-Small Cell Lung Cancer (NSCLC, 81.66%) out of which squamous cell carcinoma constituted 55.00% and adenocarcinoma 21.67%, followed by small cell carcinoma at 18.33%. Overall, 46.67% of the patients belonged to TNM staging IVA followed by IIIB (25.00%). The levels of ANC, platelet count, NLR and PLR were significantly elevated and ALC was decreased in cases as compared to control. There was no statistically significant association between the inflammatory markers ANC, ALC, platelet counts, NLR and PLR with the histopathological type of lung cancer. Mean ANC, platelet count, NLR and PLR were found to be significantly elevated in late stages of lung cancer, whereas, ALC had no such association with the stages of lung cancer. Conclusion: Inflammatory markers (ANC, platelet count, NLR, PLR, ALC) can serve as valuable prognostic biomarkers in lung cancer and can easily be used in resource-limited areas. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus complicates 1-14% pregnancies worldwide, it not only influences immediate maternal and neonatal outcomes but also increases the risk of future T2DM in the woman and her children. Aim of this study: To screen the primigravida, using 75gm OGCT one step, single value screening and diagnostic procedure and correlating their blood glucose values with neonatal birthweight. Material and Methods: Prospective observational study was done in the department of Obstetrics and Gynecology, Shadan Institute Of Medical Sciences, Teaching Hospital And Research Center for duration of 6 months that is from May 2022 to October 2022 on 100 primigravidae. Results: In this study, incidence of GDM was 11%, incidence of Glucose Intolerance was 12%, Mean Neonatal Birth Weight for normal glucose tolerance was 2.75kgs, impaired glucose tolerance was 3.03kgs and GDM was 3.22kgs, incidence of preterm labour with normal glucose tolerance was 6.4%, glucose intolerance was 8.3% and GDM was up to 18.2%, incidence of preeclampsia in normal blood glucose values was 10.3%, glucose intolerance was 16.6% and GDM was 18.2%,rate of caesarian section in normal glucose tolerance was 36.3%, impaired glucose tolerance was 75% and GDM was 63.6%, congenital anomalies among normal glucose tolerance was 0% and GDM was 9.1%, IUD among normal glucose tolerance was 1.1% and GDM was of 9.1%. Conclusion: In resource limited countries like India, DIPSI recommended one step, single value test irrespective of the last meal, is a very simple, cost effective and feasible procedure for universal screening and diagnosis of GDM. It is adopted by Ministry of Health (Government of India) for screening of GDM. The key finding here is that the risk of overweight and obese children rises in step with higher levels of blood sugar during pregnancy. By treating Gestational Diabetes, future risk of children becoming overweight, obese, PCOS, diabetes drops considerably. [ABSTRACT FROM AUTHOR]

To summarise existing systematic reviews which assessed the effects of physical exercise on activities of daily living, walking, balance and visual processing in people with dementia or mild cognitive impairment In this overview of systematic reviews and meta-analyses, seven electronic databases were searched to identify eligible reviews published between January 2015 and April 2021. A total of 30 systematic reviews were identified and included in the overview. The most frequent type of exercise for the intervention group was multimodal exercises. Mind-body exercises, exergames, dance intervention and aerobic exercise were other exercise types. Most of the reviews reported that exercise is significantly effective for improving activities of daily living (SMD 95%CI, from 0.27 to 1.44), walking (SMD 95%CI, from 0.08 to 2.23), balance (SMD 95%CI, from 0.37 to 2.24) and visuospatial function (SMD 95%CI, from 0.16 to 0.51), which are among the most leading determinants of independent living in individuals with dementia or mild cognitive impairment. Evidence has shown that exercise (especially multicomponent exercise programmes including cognitive, physical and multitasking exercises) with sufficient intensity improves the activities of daily living skills. Exercise also improves walking, balance and visual processing, which can provide a more independent life for people with dementia and mild cognitive impairment. Cognitively impaired people should therefore be encouraged to exercise regularly in order to be more independent. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2019192 [ABSTRACT FROM AUTHOR]

Introduction: Experiences at time of delivery not only influence women's self-esteem and mother-child bonding but may also have impact on future birthing preferences. Various factors may influence women's birthing experiences and thus overall maternal health and utilisation of institutional health services. Respectful maternity care is an individual-centric approach aimed at recognizing women's preferences and needs thereby promoting skilled assistance during childbirth. Objectives: To study various factors affecting women experiences at childbirth at different health care facilities of central India. To give recommendations for formulating policies towards respectful maternal care. Material and Methods: Descriptive Cross-sectional survey of 510 women delivering at different health facilities conducted over a period of 3months at Department of Obstetrics and Gynecology, PCMS, Bhopal. Factors related to pregnant women, family, staff, and hospital setup which may influence women experiences were assessed using a 20-item based questionnaire as tool. Results: Total 510women were interviewed(mean age 27.8yrs, overall literacy rate90%). Overall, 41% reported good birthing experience. Facility-wise deliveries were, medical college(33%), district hospital and PHC(41%), private set ups(20%), Dai(5%). Factors commonly associated with good birthing experience were delivery at private setup(55%), consideration for privacy(75%), good family support(40%), shorter labour duration(40%), consent prior to examinations(58%), vaginal delivery(43%), adequate pain relief(49%) and good neonatal outcome(44%). Women delivered by Dai(50%), those left unattended(50%) and those experiencing physical or verbal abuse(75%) reported overall bad experiences. Majority(70%) with good experience looked forward to future pregnancies. Conclusion: Regular feedbacks and audit of factors influencing women's birthing experiences take priority. Respectful maternity care by promoting institutional deliveries would thus reduce overall maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]