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Abstract Background Muscle strength is essential for healthy ageing. Handgrip strength (HGS) has been recommended by expert bodies as the preferred measure of muscle strength, in addition to being considered a strong predictor of overall health. Cross‐sectional studies have shown several potential factors associated with HGS, but a systematic review of factors predicting HGS over time has not previously been conducted. The aim of this study is to systematically review the literature on the factors associated with adult HGS [at follow‐up(s) or its rate of change] across the life course. Methods Searches were performed in MEDLINE via Ebsco, Embase and SPORTDiscus databases. Longitudinal studies assessing potential factors impacting adult HGS over time were included in the analyses. Based on previously established definitions of consistency of results, a semiquantitative analysis was conducted using the proportions of studies supporting correlations with HGS. Results A total of 117 articles were included in this review. Factors associated with HGS were grouped into 11 domains: demographic, socioeconomic, genetic, early life, body composition, health markers/biomarkers, health conditions, psychosocial, lifestyle, reproductive and environmental determinants. Overall, 103 factors were identified, of which 10 showed consistent associations with HGS over time (i.e., in at least four studies with ≥60% agreement in the direction of association). Factors associated with greater declines in HGS included increasing age, male sex, higher levels of inflammatory markers and the presence of cardiovascular diseases. Education level, medication use, and self‐rated health were not associated with the rate of change in HGS. Increased birth weight was associated with a stronger HGS over time, whereas depressive symptoms were linked to a weaker HGS, and smoking habits showed null associations. Conclusions Comparison between studies and estimation of effect sizes were limited due to the heterogeneity in methods. Although sex and age may be the main drivers of HGS decline, it is crucial to prioritize modifiable factors such as inflammation and cardiovascular diseases in health interventions to prevent greater losses. Interventions to improve birth weight and mental health are also likely to produce positive effects on muscle strength. Our results point to the complexity of processes involving muscle strength and suggest that the need to better understand the determinants of HGS remains.

This paper addresses the pervasive challenge of localization within indoor navigation systems. Many existing systems grapple with this issue, relying on marker-based methods, Bluetooth beacon localization, and image processing. However, these solutions often necessitate the placement of predetermined markers within the environment, presenting limitations such as marker deterioration over time, spatial constraints, and associated costs. In response, we propose a novel point cloud registration-based approach. This method involves the creation of a comprehensive global point cloud representing the entire indoor environment, effectively serving as a three-dimensional virtual map. Concurrently, a mixed-reality device is utilized to generate a local point cloud specific to the device’s current location within the building. By aligning and registering the local cloud with the global counterpart, the device’s precise location within the virtual map can be determined. This approach enables seamless navigation within indoor environments without the reliance on physical markers, offering a versatile and cost-effective solution to the challenge of localization in indoor navigation systems. Finally, an error analysis was also done to test localization accuracy for different illumination conditions, demonstrating the effectiveness of this method.

Abstract Background Most estimates of rheumatoid arthritis (RA) prevalence, including all official figures in Australia and many other countries, are based on self-report. Self-report has been shown to overestimate RA, but the ‘gold standard’ of reviewing individual medical records is costly, time-consuming and impractical for large-scale research and population monitoring. This study provides an algorithm to estimate RA cases using administrative data that can be adjusted for use in multiple contexts to provide the first approximate RA cohort in Australia that does not rely on self-report. Methods Survey data on self-reported RA and medications from 25 467 respondents of the Australian Longitudinal Study on Women’s Health (ALSWH) were linked with data from the national medication reimbursement database, hospital and emergency department (ED) episodes, and Medicare Benefits codes. RA prevalence was calculated for self-reported RA, self-reported RA medications, dispensed RA medications, and hospital/ED RA presentations. Linked data were used to exclude individuals with confounding autoimmune conditions. Results Of 25 467 survey respondents, 1367 (5·4%) women self-reported disease. Of the 26 840 women with hospital or ED presentations, 292 (1·1%) received ICD-10 codes for RA. There were 1038 (2·8%) cases by the medication database definition, and 294 cases (1·5%) by the self-reported medication definition. After excluding individuals with other rheumatic conditions, prevalence was 3·9% for self-reported RA, 1·9% based on the medication database definition and 0·5% by self-reported medication definition. This confirms the overestimation of RA based on self-reporting. Conclusions We provide an algorithm for identifying individuals with RA, which could be used for population studies and monitoring RA in Australia and, with adjustments, internationally. Its balance of accuracy and practicality will be useful for health service planning using relatively easily accessible input data.

Abstract Background Network analysis, commonly used to describe the patterns of multimorbidity, uses the strength of association between conditions as weight to classify conditions into communities and calculate centrality statistics. Our aim was to examine the robustness of the results to the choice of weight. Methods Data used on 27 chronic conditions listed on Australian death certificates for women aged 85+. Five statistics were calculated to measure the association between 351 possible pairs: odds ratio (OR), lift, phi correlation, Salton cosine index (SCI), and normalised-joint frequency of pairs (NF). Network analysis was performed on the 10% of pairs with the highest weight according to each definition, the ‘top pairs’. Results Out of 56 ‘top pairs’ identified, 13 ones were consistent across all statistics. In networks of OR and lift, three of the conditions which did not join communities were among the top five most prevalent conditions. Networks based on phi and NF had one or two conditions not part of any community. For the SCI statistics, all three conditions which did not join communities had prevalence below 3%. Low prevalence conditions were more likely to have high degree in networks of OR and lift but not SCI. Conclusion Use of different statistics to estimate weights leads to different networks. For exploratory purposes, one may apply alternative weights to identify a large list of pairs for further assessment in independent studies. However, when the aim is to visualise the data in a robust and parsimonious network, only pairs which are selected by multiple statistics should be visualised.

Hysterectomy, removal of the uterus, is a commonly performed surgery for gynaecological morbidities. Emerging evidence indicates that hysterectomy performed before age 45 (early hysterectomy), is associated with considerable risks to women’s health. While most evidence on hysterectomy is from high-income settings, national surveys from India report high prevalence of early hysterectomy in specific regions, as well as higher prevalence amongst women in rural areas and with less education. The median age at hysterectomy in India is close to ten years before the onset of natural menopause. India has recently introduced national guidelines to address early hysterectomy, but large evidence gaps on the causes and consequences remain – which in turn limits the potential effectiveness of interventions at the clinical, health system and community level. Methods SAHELI is a Team Science study that will examine: (i) individual, social and health system determinants of early hysterectomy; (ii) women’s treatment pathways to hysterectomy and for gynaecological morbidity in general; and (iii) the consequences of undergoing hysterectomy on women’s physical, mental, economic and social well-being across the life course. This mixed-methods study includes population surveys amongst women in ages 25–49 in three high-prevalence states; qualitative health systems research to trace treatment journeys with women, health care providers and other stakeholders; evidence syntheses; and knowledge translation activities to ensure findings inform co-produced strategies and interventions. The study is grounded in a feminist epidemiology approach, aiming to examine individual and structural causes of vulnerability and prioritising the views of women, particularly in knowledge translation. Conclusions SAHELI, implemented by an all-women, multi-disciplinary team, is the first study in India to examine the causes and consequences of hysterectomy in a life course approach. We aim to influence interventions, policy and future research on women’s health, particularly access to quality gynaecological care and comprehensive health services through the life course.

Background: Demonstrating keratin is crucial in diagnosing various epithelial pathologies and is typically done through histological and immunohistochemical (IHC) methods. While IHC staining for keratin is highly specific, it can be costly and time-consuming. Therefore, common histological staining methods for keratin, suitable for routine histotechniques labs, are gaining importance. Methodology: Twenty formalin-fixed, paraffin-embedded tissue blocks, each representing histologically confirmed normal oral mucosa (NOM), hyperorthokeratosis (HOK), and well-differentiated squamous cell carcinoma (WDSCC), were retrieved. Five histological sections of 4-μ thickness from each block were stained using routine hematoxylin and eosin (H and E), modified pap stain (mPap), Ayoub-Shklar (AS), Dane-Herman (DH), and Alcian blue-PAS stains (AB-PAS). Two independent observers evaluated the stained sections and scored staining specificity and intensity. Statistical comparisons were made. Results: All sections of NOM, HOK, and WDSCC showed positive staining for keratin with each of the five stains used. The staining specificity and intensity scores were highest with the AS stain and lowest with the AB-PAS stain. Conclusion: Routine H and E, mPap, AS, and DH stains effectively stained keratin with adequate intensity in NOM, HOK, and WDSCC. However, while AB-PAS stain also positively stained keratin, its staining intensity was poor across all three tissue types.

Abstract Objective To develop a consumer and community involvement (CCI) strategy for the Women’s Health Research, Translation and Impact Network (WHRTN), an initiative of the Australian Health Research Alliance (AHRA). Type of program A national network, comprising representatives from 14 nationally-accredited research translation centres that aims to embed CCI at a systems level, to improve equity and health outcomes across women’s health. Methods A CCI Sub-Committee of WHRTN was established, chaired by a Consumer Advisor/Advocate. This committee invited both internal and external Consumer Advisor/Advocates to participate in a workshop, to guide the development of WHRTN’s CCI Strategy in women’s health research. Results A CCI Strategy document was written with input from workshop attendees and leading academics in women’s health and has now been implemented into WHRTN, informing all aspect of the Network’s programs and activities. Discussion Broad and early consumer involvement can facilitate meaningful partnerships between researchers and community, and enable genuine consumer contributions to research across strategy development, priority setting and undertaking research. Appropriate finances and time need to be allocated for CCI, with training in CCI a key enabler for its effective implementation.

Grain amaranth (Amaranthus hypochondriacus L.) has gained increasing attention as a potential nutrient-rich crop with numerous health benefits. The present study was carried out, during the summer (kharif) season of 2019 and 2020 at College of Agriculture, Odisha University of Agriculture and Technology, Bhubaneswar, Odisha to evaluate morpho-quantitative and biochemical parameters of grain amaranth. Four varieties of grain amaranth in five different replications were taken. Morpho-quantitative assessment indicated that, Suvarna (11.23 q/ha) yielded the most, GA 2 flowers opened 50% after 45.68 days, whereas BGA 2 took 51.52 days. The RMA 7 variety matured in 102.5 days, while the Suvarna variety matured in 104.2 days. RMA 7 had the longest panicle (38.9 cm), whereas Suvarna had the smallest (35.68 cm). Suvarna had the most plants (74.3), followed by BGA 2 (73.5). Biochemical analysis revealed that, BGA 2 contained more chlorophyll (1.537 mg/g), and RMA 7 had more total carbohydrate (319 mg/g). Moreover, BGA 2, GA 2, Suvarna and RMA 7 exhibited comparable phenol content. Moreover, Fe (66 mg/100 g), Mg (284.5 mg/100 g), Mn (5.71 mg/100 g), Zn (11.3 mg/100 g), Ca (178.7 mg/100 g), and K (400.50 mg/100 g) were detected by ICP-OES analysis. FTIR and HPTLC analysis indicated more number of functional group present in the varieties. Thus, the present study unveiled that seeds of grain amaranthus varieties are rich source of different essential elements, and other essential biochemical parameters, with higher antioxidant activity. Hence this pseudocereal can be used to provide good food supplements to the infants as well as adults.

Abstract Objective: This study examined adherence to dietary guidelines and symptoms of sleep problems (e.g. taking a long time to fall sleep or waking up early) and their associations in a sample of older Australian women (68–73 years of age). Design: This was a population-based cross-sectional study. Adherence to the dietary guidelines was measured using a validated FFQ and reported as a diet quality score. Symptoms of sleep problems were measured using five questions and a total score was derived. Multivariate linear regression was used to investigate the association between these outcomes, adjusted for the potential confounding influence of demographic (i.e. age and marital status) and lifestyle (i.e. physical activity, stress, alcohol intake, sleep medication use) variables. Setting: Respondents from the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health who completed Survey 9 were included. Participants: Data from n 7956 older women (mean age ± sd: 70·8 ± 1·5) were included. Results: 70·2 % reported having at least one symptom and 20·5 % had between 3 and 5 symptoms of sleep problems (mean score ± sd: 1·4 ± 1·4, range 0–5). Adherence to dietary guidelines was poor with an average diet quality score of 56·9 ± 10·7 (range 0–100). Better adherence to dietary guidelines was associated with fewer sleep problem symptoms (β: –0·065, 95 % CI: –0·012, –0·005) and remained significant after adjusting for confounding influences. Conclusions: These findings support the evidence that adherence to dietary guidelines is associated with symptoms of sleep problems in older women.

Abstract Purpose: To report a case of a young female who presented with scotoma in the right eye for few days. Case Report: Krill's disease or acute retinal pigment epithelitis (ARPE) is a self-limiting retinal disease with no specific treatment. Typical clinical and imaging features helped us to diagnose her with ARPE. Intravenous methylprednisolone (IVMP), which gives a rapid anti-inflammatory response, was advised. An SD-OCT scan post-injection showed a reduction in hyperreflectivity and height of lesion at day 3 and near total resolution by day 5. Conclusion: This case suggests rapid resolution of ARPE with the use of IVMP.

Endometriosis is a common yet under-recognised chronic inflammatory disease, affecting 176 million women, trans and gender diverse people globally. The National Endometriosis Clinical and Scientific Trials (NECST) Registry is a new clinical registry collecting and tracking diagnostic and treatment data and patient-reported outcomes on people with endometriosis. The registry is a research priority action item from the 2018 National Action Plan for Endometriosis and aims to provide large-scale, national and longitudinal population-based data on endometriosis. Working groups (consisting of patients with endometriosis, clinicians and researchers) developing the NECST Registry data dictionary and data collection platform started in 2019. Our data dictionary was developed based on existing and validated questionnaires, tools, meta-data and data cubes – World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project, endometriosis CORE outcomes set, patient-reported outcome measures, the International Statistical Classification of Diseases-10th Revision Australian Modification diagnosis codes and Australian Government datasets: Australian Institute for Health and Welfare (for sociodemographic data), Medicare Benefits Schedule (for medical procedures) and the Pharmaceutical Benefits Scheme (for medical therapies). The resulting NECST Registry is an online, secure cloud-based database, prospectively collecting minimum core clinical and health data across eight patient and clinician modules and longitudinal data tracking disease life course. The NECST Registry has ethics approval (HREC/62508/ MonH-2020) and is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000987763).

Abstract Aims The role of depression in subsequent infertility, miscarriage and stillbirth remains unclear. This study aimed to examine the association of a history of depression with these adverse outcomes using a longitudinal cohort study of women across their reproductive life span. Methods This study used data from participants in the Australian Longitudinal Study on Women’s Health who were born in 1973–1978. Participants (N = 8707) were followed up every 3 years from 2000 (aged 22–27) to 2018 (aged 40–45). Information on a diagnosis of depression was collected from each survey, and antidepressant medication use was identified through pharmaceutical prescription data. Histories of infertility, miscarriage, and stillbirth were self-reported at each survey. Time-lagged log-binomial models with generalized estimating equations were used to assess the association of a history of depression up to and including in a given survey with the risk of fertility issues in the next survey. Results Women with a history of depression (excluding postnatal depression) were at higher risk of infertility [risk ratio (RR) = 1.34, 95% confidence interval (CI): 1.21–1.48], miscarriage (RR = 1.22, 95%CI: 1.10–1.34) and recurrent miscarriages (≥2; RR = 1.39, 95%CI: 1.17–1.64), compared to women without a history of depression. There were too few stillbirths to provide clear evidence of an association. Antidepressant medication use did not affect the observed associations. Estimated RRs of depression with infertility and miscarriage increased with age. Conclusions A history of depression was associated with higher risk of subsequent infertility, miscarriage and recurrent miscarriages.

Background: Over the last decade, an emerging role of novel cytokines in the pathogenesis of gestational diabetes mellitus (GDM) has been proposed. The present study was implemented to provide a more accurate estimate of the effect size of the association between leptin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) and the risk of GDM.Methods: Online databases were looked up to January 2023 using the search string: (leptin OR TNF-α OR IL-6) AND “gestational diabetes.” Observational studies investigating the association of selected cytokines and GDM risk were included. Odds ratios and their 95% confidence intervals (CIs) were extracted and random-effects models were used to estimate the pooled effect.Results: Twenty-four studies were included in the meta-analysis. A significant association was found between higher circulating leptin and the risk of GDM and the pooled estimate was 1.16 (95%CI: 1.07, 1.27). Higher circulating levels of IL-6 and TNF-α were associated with increased risk of GDM, and the pooled estimates were 1.35 (95%CI: 1.05, 1.73) and 1.28 (95%CI: 1.01, 1.62), respectively.Conclusions: The studied cytokines could be implicated in the GDM pathogenesis and used as potential biomarkers for assessing the GDM risk. Additional longitudinal studies with large sample sizes are needed for a further evaluation of these findings.

Abstract Background Hysterectomy, particularly when conducted in women younger than 45 years, has been associated with increased risk of non-communicable diseases. In India, research indicates that hysterectomy is a common procedure for women, but there have been no studies on its long-term effects. We examined patterns of hysterectomy amongst women in India and associations with their health and well-being in later life. Methods This analysis utilised the first wave of the Longitudinal Study on Aging in India, a nationally representative study of adults that included a module on health and well-being. We analysed data on 35,083 women ≥45 years in India. We estimated prevalence of hysterectomy and performed multivariable logistic regression to identify associated risk factors and to examine the association between hysterectomy status and eight self-reported chronic conditions, hospitalisation and mobility. Results The prevalence of hysterectomy among women >=45 years was 11.4 (95% CI: 10.3, 12.6), with higher odds among urban women (aOR: 1.39; 1.17,1.64) and higher economic status (highest compared to lowest quintile: aOR: 1.95; 1.44, 2.63). Hysterectomy history was associated with four chronic conditions: hypertension (aOR: 1.51; 95% CI: 1.28, 1.79), high cholesterol (aOR: 1.43; 1.04, 1.97), diabetes (aOR: 1.69; 1.28, 2.24), and bone/joint disease (aOR: 1.54; 1.20, 1.97) and higher odds of any hospitalisation in the past year (aOR: 1.69; 1.36, 2.09). Conclusions In India, evidence suggests that hysterectomy is associated with major chronic conditions. The assessment for hysterectomy as a treatment option for gynaecological morbidity should consider potential health consequences in later life.

Abstract Background Symptoms can be strong drivers for initiating interaction with the health system, especially when they are frequent, severe or impact on daily activities. Research on symptoms often use counts of symptoms as a proxy for symptom burden, however simple counts don’t provide information on whether groups of symptoms are likely to occur together or whether such groups are associated with different types and levels of healthcare use. Women have a higher symptom burden than men; however studies of symptom patterns in young women are lacking. We aimed to characterise subgroups of women in early adulthood who experienced different symptom patterns and to compare women’s use of different types of health care across the different symptom subgroups. Methods Survey and linked administrative data from 7 797 women aged 22–27 years in 2017 from the 1989–95 cohort of the Australian Longitudinal Study on Women’s Health were analysed. A latent class analysis was conducted to identify subgroups of women based on the frequency of 16 symptom variables. To estimate the associations between the latent classes and health service use, we used the “Bolck, Croon and Hagenaars” (BCH) approach that takes account of classification error in the assignment of women to latent classes. Results Four latent classes were identified, characterised by 1) low prevalence of most symptoms (36.6%), 2) high prevalence of menstrual symptoms but low prevalence of mood symptoms (21.9%), 3) high prevalence of mood symptoms but low prevalence of menstrual symptoms, (26.2%), and high prevalence of many symptoms (15.3%). Compared to the other three classes, women in the high prevalence of many symptoms class were more likely to visit general practitioners and specialists, use more medications, and more likely to have had a hospital admission. Conclusions Women in young adulthood experience substantially different symptom burdens. A sizeable proportion of women experience many co-occurring symptoms across both physical and psychological domains and this high symptom burden is associated with a high level of health service use. Further follow-up of the women in our study as they enter their late 20 s and early 30 s will allow us to examine the stability of the classes of symptoms and their associations with general health and health service use. Similar studies in other populations are needed to assess the generalisability of the findings.

Despite an increasing number of studies demonstrating the potential mental health benefits of greenspace, few longitudinal studies have been reported. We aimed to assess associations between two metrics of residential greenspace exposure and anxiety symptoms in a cohort of Australian women living in major cities.Our study comprised 3,938 women, born between 1973 and 78. Anxiety symptoms in the previous month were assessed at follow-up every three years during 2003–2018, using the anxiety subscale of the Goldberg Anxiety and Depression Scale. The three-month seasonal average normalized difference vegetation index (NDVI) was estimated from 30 m Landsat satellite images in a 500 m buffer (NDVI500m) around participants’ address at each survey (higher NDVI indicates more green vegetation). The annual fractional cover of non-photosynthesising vegetation was estimated (fNPV500m, with higher values indicating greater levels of dead leaf litter or dry grass).A generalised estimating equation assessed associations between greenspace measures and anxiety symptoms (as odds ratios [ORs]), adjusting for repeated outcomes and individual-level covariates. Additional analyses focused on women experiencing substantial changes in between-survey exposure due to moving, and adjusting for nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure, among others.A standard deviation (SD) (0.12 units) increase in NDVI500m was significantly associated with lower odds of anxiety symptoms (OR: 0.96, 95% CI: 0.93–0.99) in the adjusted model. An SD (5.2%) increase in annual fNPV500m was consistent with the direction expected for that exposure, but not significant in the adjusted model (OR: 1.03, 95% CI: 0.99–1.07). NDVI500m was modestly attenuated when air pollutants were adjusted for, while fNPV500m only became significant when PM2.5 was adjusted for. Between-survey contrasts had no clear effect for NDVI500m. Moving to a higher fNPV500m area, compared with a similar fNPV500m area, was consistently associated with anxiety symptoms (OR: 1.15, 95% CI: 1.02–1.31). NDVI500m was generally associated with lower odds of anxiety symptoms, while fNPV500m was generally associated with higher odds of anxiety, depending on the covariates considered.

Abstract Background Previous studies of lifestyle characteristics and risk of miscarriage have mostly been retrospective and failed to account for induced abortions. We examine whether pre-pregnancy body-mass index, alcohol intake and smoking influence the risk of miscarriage after accounting for induced abortions. Methods We conducted a prospective cohort study of 9213 women with 26,594 pregnancies participating in the Australian Longitudinal Study on Women’s Health. We examined whether body-mass index, smoking and alcohol intake prior to pregnancy was associated with miscarriage. We estimated adjusted relative risks (RR) using generalized estimating equations with an exchangeable correlation matrix. We explored the impact of accounting for induced abortion by first excluding all induced abortions, and secondly including 50% of induced abortions in the comparison group. Results Of the 26,592 pregnancies which occurred during the follow-up period, 19% ended in a miscarriage. We observed an increased risk of miscarriage according to pre-pregnancy obesity compared to normal weight (adjusted RR 1.13; 95% CI 1.05, 1.21), smoking between 10 and 19 cigarettes per day compared to not smoking (adjusted RR 1.13; 95% CI 1.02, 1.25), but not smoking 20 or more cigarettes per day (adjusted RR 1.07; 95% CI 0.94, 1.21) and risky drinking (≥2 units per day; adjusted RR 1.15; 95% CI 1.03, 1.28) compared to low risk drinking (

Background and Aims: To compare the sedoanalgesic effects of dexmedetomidine alone or with combination of ketamine. Material and Methods: After getting ethical approval and informed patient consent, 60 adult surgical patients, were randomly divided into two groups. Group KD (n = 30); received dexmedotomidine 0.5 μg/kg/h mixed with ketamine 0.5 mg/kg/h and Group DEX (n = 30); received dexmedotomidine at 0.5 μg/kg/h infusion only. In both the groups, study drugs were titrated (dexmedetomidine- 0.2-0.7 μg/kg/h and ketamine 0.2-0.7 mg/kg/h) to achieve target sedation. Hemodynamic variables, pain scores, sedation scores, and patient satisfaction were recorded. Qualitative and Quantitative data were analyzed with Pearson Chi-squared test and analysis of variance test, respectively. All analyses were done by using statistical package for social sciences (SPSS) version 16.0. Results: Pain scores were higher in group DEX than in group KD at 2 h and 4 h which was statistically significant (P < 0.05). At the end of 2 h, sedation scores were higher in group KD than in group DEX and was statistically significant (P < 0.05). Length of intensive care unit stay was almost comparable in both groups, and the time to tracheal extubation was lesser in ketamine-dexmedetomidine group as compared to the dexmedetomidine alone group. However the difference was statistically non-significant. Conclusions: By combining dexmedetomidine with ketamine we observed lower incidence of hypotension and bradycardia. Dexmedetomidine with ketamine combination therapy could be used safely and effectively as sedo-analgesic agent.

Objective: The aim is to study respiratory diseases in children staying in a stone quarry. Methods: Prospective longitudinal study. All 85 children staying in the stone quarry near Pune were followed for respiratory symptoms and nutritional status by monthly visits for a period of 18 months. At the time of enrolment, Hemogram, Chest X- ray Postero-anterior view (PA), Tuberculin Test (TT), Peak Expiratory Flow Rate{PEFR }(Of children age: 5-12 yrs.) was done. Results: In those 85 children, there were 394 episodes of respiratory infections (3.09 episodes per child per year). They had 53 episodes of pneumonia requiring admission. TT test was positive in 9.4%of children. Eosinophilia was present in 16.47% of children. PEFR in these children was significantly lower than that of children of the same height (P < 0.05); 64.2% of all children were malnourished; 42.8% had moderate malnutrition and 21.4% had severe malnutrition. None of them had received even vaccines provided under EPI completely. Conclusion: Children staying in the stone quarry have frequent respiratory infections. They have a higher rate of pneumonia requiring admission. TT positivity is high. They have a lower PEFR. Immunization coverage is poor.

Background Social relationships are associated with mortality and chronic conditions. However, little is known about the effects of social relationship satisfaction on multiple chronic conditions (multimorbidity).Aims To examine whether social relationship satisfaction is associated with the accumulation of multimorbidity.Methods Data from 7 694 Australian women who were free from 11 chronic conditions at 45–50 years of age in 1996 were analysed. Five types of social relationship satisfaction (partner, family members, friends, work and social activities) were measured approximately every 3 years and scored from 0 (very dissatisfied) to 3 (very satisfied). Scores from each relationship type were summed to provide an overall satisfaction score (range: ≤5–15). The outcome of interest was the accumulation of multimorbidity in 11 chronic conditions.Results Over a 20-year period, 4 484 (58.3%) women reported multimorbidities. Overall, the level of social relationship satisfaction had a dose–response relationship with the accumulation of multimorbidities. Compared with women reporting the highest satisfaction (score 15), women with the lowest satisfaction (score ≤5) had the highest odds of accumulating multimorbidity (odds ratio (OR)= 2.35, 95% confidence interval (CI): 1.94 to 2.83) in the adjusted model. Similar results were observed for each social relationship type. Other risk factors, such as socioeconomic, behavioural and menopausal status, together explained 22.72% of the association.Conclusions Social relationship satisfaction is associated with the accumulation of multimorbidity, and the relationship is only partly explained by socioeconomic, behavioural and reproductive factors. Social connections (eg, satisfaction with social relationships) should be considered a public health priority in chronic disease prevention and intervention.

Abstract Background To determine the relationship between clusters of back pain and joint pain and prescription opioid dispensing. Methods Of 11,221 middle-aged participants from the Australian Longitudinal Study of Women’s Health, clusters of back pain and joint pain from 2001 to 2013 were identified using group-based trajectory modelling. Prescription opioid dispensing from 2003 to 2015 was identified by linking the cohort to Pharmaceutical Benefit Scheme dispensing data. Multinomial logistic regression was used to examine the association between back pain and joint pain clusters and dispensing of prescription opioids. The proportion of opioids dispensed in the population attributable to back and join pain was calculated. Results Over 12 years, 68.5 and 72.0% women reported frequent or persistent back pain and joint pain, respectively. There were three clusters (‘none or infrequent’, ‘frequent’ and ‘persistent’) for both back pain and joint pain. Those in the persistent back pain cluster had a 6.33 (95%CI 4.38-9.16) times increased risk of having > 50 opioid prescriptions and those in persistent joint pain cluster had a 6.19 (95%CI 4.18-9.16) times increased risk of having > 50 opioid prescriptions. Frequent and persistent back and joint pain clusters together explained 41.7% (95%CI 34.9-47.8%) of prescription opioid dispensing. Women in the frequent and persistent back pain and joint pain clusters were less educated and reported more depression and physical inactivity. Conclusion Back pain and joint pain are major contributors to opioid prescription dispensing in community-based middle-aged women. Additional approaches to reduce opioid use, targeted at those with frequent and persistent back pain and joint pain, will be important in order to reduce the use of opioids and their consequent harm in this population.

Purpose Previous studies have identified associations between individual reproductive factors and chronic disease risk among postmenopausal women. However, few have investigated the association of different markers of reproductive function, their interactions and risk factors of chronic disease among women approaching menopause. The Menarche-to-PreMenopause (M-PreM) Study aims to examine the relationship between reproductive factors across the reproductive lifespan and risk indicators for chronic disease among women in their early-to-mid-40s. The purpose of this cohort profile paper is to describe the rationale, study design and participant characteristics of the M-PreM Study.Participants Women born in 1973–1978 who participated in the Australian Longitudinal Study on Women’s Health (ALSWH) were invited to undertake a clinical or self-administered assessment. A total of 1278 women were recruited from June 2019 to June 2021.Findings to date The study measures included functional, cognitive and cardiometabolic tests, anthropometry, spirometry, respiratory health questionnaires, physical activity, sleep patterns, sex hormones, and cardiovascular and metabolic markers; whereas blood and saliva samples were used for the analysis of genetic variants of genes associated with reproductive characteristics and chronic disease. The mean age of the clinic and self-assessed participants was 44.6 and 45.3 years, respectively. The menopausal status of participants was similar between the two arms of the study: 38%–41% premenopausal, 20% perimenopausal, and 36% took oral contraception or hormone replacement therapy. Approximately 80% of women had at least one child and participants reported experiencing pregnancy complications: preterm birth (8%–13% of pregnancies), gestational diabetes (10%) and gestational hypertension (10%–15%).Future plans The biomedical data collected in the M-PreM Study will be linked to existing ALSWH survey data on sociodemographic factors, health behaviour, reproductive function, and early life factors collected over the past 20 years and health administrative data. The association between reproductive factors and risk indicators of chronic disease will be analysed.

An experiment was conducted at research farm of ICAR-Indian Institute of Farming Systems Research, Modipuram, Uttar Pradesh during 2016–17 to 2018–19 to develop integrated farming systems (IFS) model which has diverse commodities/components, viz. crops (1.04 ha), dairy (2 Murrah buffaloes and 1 Gir cow), horticulture (0.22 ha), fishery (0.1 ha), mushroom (0.02 ha), poultry (10 birds), vermicompost unit (0.02 ha), kitchen garden (0.002 ha) and boundary plantation with fruit trees (200 m in running length). The total productivity of all cropping sequences surged up to 124.96 tonnes/1.04 ha/year when yields of the whole system were transformed into sugarcane equivalent yield (SEY). Gross and net returns from crop components of IFS model were obtained in the extent of `282×103/1.04 ha/ year and `199×103/1.04 ha/year and B:C ratio 3.37. The overall farm product of all components in the form of SEY was 246.95 tonnes/1.5 ha/year and 164.63 tonnes/ha/year. Similarly, gross return from involving all components of IFS model was erected at `777×103/1.5 ha/year and `518×103/ha/year and net return `491×103/1.5 ha/year and `328 × 103/ha/year with B:C ratio of 3.37 for the entire IFS model. Given total availability of farm-based waste (19950 kg/ year) was recycled within the system in the form of compost, vermicompost (VC), crops residues, litter falls, weeds and green manure (GM). As regards to livelihood security, the IFS approach had adapted to meet the homegrown family needs of cereals, pulses, oils, fruits, milk, meat, eggs and vegetables.

Abstract Background Healthy Living after Cancer (HLaC) was a national dissemination and implementation study of an evidence-based lifestyle intervention for cancer survivors. The program was imbedded into existing telephone cancer information and support services delivered by Australian state-based Cancer Councils (CC). We report here the reach, effectiveness, adoption, implementation, and maintenance of the program. Methods In this phase IV study (single-group, pre-post design) participants - survivors of any type of cancer, following treatment with curative intent - received up to 12 nurse/allied health professional-led telephone health coaching calls over 6 months. Intervention delivery was grounded in motivational interviewing, with emphasis on evidence-based behaviour change strategies. Using the RE-AIM evaluation framework, primary outcomes were reach, indicators of program adoption, implementation, costs and maintenance. Secondary (effectiveness) outcomes were participant-reported anthropometric, behavioural and psychosocial variables including: weight; physical activity; dietary intake; quality-of-life; treatment side-effects; distress; and fear of cancer recurrence and participant satisfaction. Changes were evaluated using linear mixed models, including terms for timepoint (0/6 months), strata (Cancer Council), and timepoint x strata. Results Four of 5 CCs approached participated in the study. In total, 1183 cancer survivors were referred (mostly via calls to the Cancer Council telephone information service). Of these, 90.4% were eligible and 88.7% (n = 791) of those eligible consented to participate. Retention rate was 63.4%. Participants were mostly female (88%), aged 57 years and were overweight (BMI = 28.8 ± 6.5 kg/m2). Improvements in all participant-reported outcomes (standardised effect sizes of 0.1 to 0.6) were observed (p

Abstract Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013–2017). Methods: A longitudinal community‐based study of self‐reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results: From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52–0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60–0.99) were less likely to have been screened both antenatally and postnatally. Conclusions: Despite improvements, perinatal mental health screening is not yet universal. One‐in‐five women are not screened both antenatally and postnatally, including women in high‐risk populations such as those who have reported emotional distress. Implications for public health: Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed.

Background: Accumulating evidence indicates early life exposure to air pollution, a suspected neurotoxicant, is negatively associated with children’s neurodevelopment. Objectives: To explore the role of multiple exposure periods to ambient particulate matter with diameter

We present three-particle mixed-harmonic correlations 〈cos⁡(mϕa+nϕb−(m+n)ϕc)〉 for harmonics m,n=1−3 for charged particles in sNN=200 GeV Au+Au collisions at RHIC. These measurements provide information on the three-dimensional structure of the initial collision zone and are important for constraining models of a subsequent low-viscosity quark–gluon plasma expansion phase. We investigate correlations between the first, second and third harmonics predicted as a consequence of fluctuations in the initial state. The dependence of the correlations on the pseudorapidity separation between particles show hints of a breaking of longitudinal invariance. We compare our results to a number of state-of-the art hydrodynamic calculations with different initial states and temperature dependent viscosities. These measurements provide important steps towards constraining the temperature dependent viscosity and longitudinal structure of the initial state at RHIC.

We present the first measurement of the proton–Ω correlation function in heavy-ion collisions for the central (0–40%) and peripheral (40–80%) Au + Au collisions at sNN=200 GeV by the STAR experiment at the Relativistic Heavy-Ion Collider (RHIC). Predictions for the ratio of peripheral collisions to central collisions for the proton–Ω correlation function are sensitive to the presence of a nucleon–Ω bound state. These predictions are based on the proton–Ω interaction extracted from (2+1)-flavor lattice QCD calculations at the physical point. The measured ratio of the proton–Ω correlation function between the peripheral (small system) and central (large system) collisions is less than unity for relative momentum smaller than 40 MeV/c. Comparison of our measured correlation ratio with theoretical calculation slightly favors a proton–Ω bound system with a binding energy of ∼ 27 MeV. Keywords: Correlations, Femtoscopy, NΩ dibaryon

Health assessments have potential to improve health of older people. This study compares long-term health care utilisation, physical functioning, and mortality for women aged 75 years or over who have had a health assessment and those who have not. Prospective data on health service use, physical functioning, and deaths among a large cohort of women born 1921-26 were analysed. Propensity score matching was used to produce comparable groups of women according to whether they had a health assessment or not. The study population included 6128 (67.3%) women who had an assessment, and 2971 (32.7%) women who had no assessment. Propensity matching produced 2101 pairs. Women who had an assessment had more use of other health services, longer survival, and were more likely to survive with high physical functioning compared to women with no assessment. Among women who had good baseline physcial functioning scores, women who had an assessment had significantly lower odds of poor outcomes at 1000 days follow-up compared to women who had no assessment (OR: 0.67, 95%CI: 0.52, 0.85). This large observational study shows the real-world potential for assessments to improve health outcomes for older women. However, they also increased health service use. This increased healthcare is likely to be an important mechanism in improving the women's health outcomes.

Context: Radiological investigations play a pivotal role in the diagnosis and treatment of a wide range of procedures. Aim: To assess the knowledge regarding adverse consequences of radiological examination and encourage awareness regarding radiation protection amongst general public. Settings and Design: A questionnaire-based cross-sectional study conducted amongst patients visiting the dental outpatient department. Materials and Methods: 1,000 adult male and female patients within the age of 20–70 years who visited the outpatient department during May–July 2017 were included in the study. Statistical Analysis: Comparison of frequencies of responses to each item with age and gender was done using chi square test. For all statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and β error at 20%. Results: 85.3% participants had visited a hospital earlier and 69.3% had undergone the procedure of an X-ray earlier. Out of those patients, only 24.7% of the participants had any knowledge about the equipment or the procedure while taking a radiograph. 5.2% of the participants were given any safety measures during the radiological procedure. 14.4% had knowledge of the risks and hazards associated with radiation. Conclusions: This short study showed that there is a need for educating the general population about the hazards and risks associated with radiation exposure.

Technological advancement is the key driver for economic growth and sustainable development. Geospatial Technologies applications and tools available today are being used for improved performance of a country towards all major verticals of economy. In a bid to attract investment and ensure hassle-free land acquisition for major projects, the Odisha government decided to create land banks for industrial development using advanced technology applications. In the present paper Geo-informatics, ICT and space technology inputs are used to create Web-GIS based solutions for Land Bank creation. High resolution ortho-images, geo-referenced digital revenue cadastral datasets, Revenue RoR data, satellite derived spatial datasets and utility attribute datasets of state department are used to create the Web-GIS Odisha land bank. Emphasis was given to develop a portal that offers an interactive platform and provide detailed information with regards to availability of industrial plots or land plot clusters based on location specific attributes in terms of connectivity, rail and road linkages and other physical and social infrastructure available in the vicinity. Conversely, the developed system helps an investor to identify suitable land plots in the vicinity of the utility, sub-utility selected by an investor as per his requirement. It enables prospective investors to identify suitable land in Odisha from the comfort of their offices. A prospective investor can define preferred parameters such as the district, size of land required, facilities available in the vicinity and proximity to existing developed infrastructure etc. based on which the portal identifies and returns information regarding the suitable land parcels available in the State. The outputs are web-hosted in public domain for use by all stakeholders interactively under GOPLUS (Govt. Odisha Portal for Land use and Services) through gis.investodisha.org.

We present a measurement of inclusive J/ψ production at mid-rapidity (|y|

Fluctuations of conserved quantities such as baryon number, charge, and strangeness are sensitive to the correlation length of the hot and dense matter created in relativistic heavy-ion collisions and can be used to search for the QCD critical point. We report the first measurements of the moments of net-kaon multiplicity distributions in Au+Au collisions at sNN=7.7, 11.5, 14.5, 19.6, 27, 39, 62.4, and 200 GeV. The collision centrality and energy dependence of the mean (M), variance (σ2), skewness (S), and kurtosis (κ) for net-kaon multiplicity distributions as well as the ratio σ2/M and the products Sσ and κσ2 are presented. Comparisons are made with Poisson and negative binomial baseline calculations as well as with UrQMD, a transport model (UrQMD) that does not include effects from the QCD critical point. Within current uncertainties, the net-kaon cumulant ratios appear to be monotonic as a function of collision energy.

New measurements of directed flow for charged hadrons, characterized by the Fourier coefficient v1, are presented for transverse momenta pT, and centrality intervals in Au+Au collisions recorded by the STAR experiment for the center-of-mass energy range sNN=7.7–200 GeV. The measurements underscore the importance of momentum conservation, and the characteristic dependencies on sNN, centrality and pT are consistent with the expectations of geometric fluctuations generated in the initial stages of the collision, acting in concert with a hydrodynamic-like expansion. The centrality and pT dependencies of v1even, as well as an observed similarity between its excitation function and that for v3, could serve as constraints for initial-state models. The v1even excitation function could also provide an important supplement to the flow measurements employed for precision extraction of the temperature dependence of the specific shear viscosity.

Abstract Objective: To determine the combined longitudinal effect of body mass index (BMI) and physical activity (PA) on health‐related quality of life (HrQoL), using the SF‐6D (SF‐36) utility measure. Methods: Five waves of self‐reported data from the 1946–51 cohort (n=5,200; data collection, 2001–2013) of the Australian Longitudinal Study on Women’s Health were used. Mixed effect models were employed to address the objective. Results: Women with high PA experienced higher HrQoL regardless of BMI group, however, for those healthy or overweight, there was a very small decline in HrQoL over time. Women reporting no PA levels experienced the lowest baseline mean SF‐6D score within each BMI group, with decreasing trajectories over the follow‐up period. The rate of decline was greatest in women with obesity. Within each BMI group, there was a large, increasing gap in HrQoL between those who reported no and low PA over time. Women with obesity and high PA experienced similar HrQoL trajectories to women with normal weight or overweight with low PA levels. Overweight women with moderate PA experienced similar HrQoL to those with low PA but normal weight. Conclusions: PA may mitigate the adverse effect of overweight and obesity on HrQoL at mid‐life, at higher activity levels. Implications for public health: PA benefits HrQoL regardless of body mass, with larger gains for those currently not physically active. Moderate to high PA may mitigate the effect of overweight and obesity.

The transversity distribution, which describes transversely polarized quarks in transversely polarized nucleons, is a fundamental component of the spin structure of the nucleon, and is only loosely constrained by global fits to existing semi-inclusive deep inelastic scattering (SIDIS) data. In transversely polarized p↑+p collisions it can be accessed using transverse polarization dependent fragmentation functions which give rise to azimuthal correlations between the polarization of the struck parton and the final state scalar mesons.This letter reports on spin dependent di-hadron correlations measured by the STAR experiment. The new dataset corresponds to 25 pb−1 integrated luminosity of p↑+p collisions at s=500 GeV, an increase of more than a factor of ten compared to our previous measurement at s=200 GeV. Non-zero asymmetries sensitive to transversity are observed at a Q2 of several hundred GeV and are found to be consistent with the former measurement and a model calculation. We expect that these data will enable an extraction of transversity with comparable precision to current SIDIS datasets but at much higher momentum transfers where subleading effects are suppressed. Keywords: Transversity, Di-hadron correlations, Interference fragmentation function