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Summary: Background: Emerging research indicates growing concern over long COVID globally, although there have been limited studies that estimate population burden. We aimed to estimate the burden of long COVID in three districts of Haryana, India, using an opportunity to link a seroprevalence study to follow-up survey of symptoms associated with long COVID. Methods: We used a population-based seroprevalence survey for COVID-19 conducted in September 2021 across Haryana, India. Adults from three purposively selected districts (Rohtak, Gurugram, and Jhajjar) were eligible to participate; 2205 of 3213 consented to participate in a survey on health status. Trained investigators administered a structured questionnaire that included demographic characteristics, self-reported symptoms of illness in the last six months before the survey, mental health, and history of COVID-19. Findings: Unadjusted regression estimates indicated positive correlations between symptomatic complaints and COVID-19 exposure, suggesting lingering effects of COVID-19 in this population. The overall physical morbidity index was higher among those who tested positive for COVID-19, as was the incidence of new cases. However, both morbidity and incidence became statistically insignificant after adjustment for multiple comparisons. Cough emerged as the only statistically significant individual persistent symptom. Sex-stratified analyses indicated significant estimates only for physical morbidity in women. Interpretation: This study is one of the first from India that uses a large population-based sample to examine longer term repercussions of COVID infections. The burden of long COVID should primarily be addressed in clinical settings, where specialised treatment for individual cases continues to evolve. Our analyses also provide insight into the size and nature of studies required to assess the population-level burden of long COVID. Funding: This paper was produced under the auspices of the Lancet COVID 19 Commission India Task Force, which was supported financially by the Reliance Foundation. The Lancet COVID 19 Commission was set up in July 2020 and submitted its final report by October 2022. This report by the India Task Force was prepared during the same period.

Iron (Fe) malnutrition in humans is a global concern which can be revised by improved Fe density in staple crops. A field experiment was performed to evaluate the effect of chelated iron on growth, yield and iron concentration in bread wheat (cv. Moomal) at Tando Jam Pakistan. The treatments included, Control (No Fe-EDTA), Soil supplement of Fe-EDTA (@ 2 kg Fe ha-1), Soil + foliar supplement of Fe-EDTA (@ 2 kg ha-1 and 0.2% Fe at booting, flowering, and milky stage), and Foliar supplement of Fe-EDTA (@ 0.2% Fe at booting, flowering and milky stages). The defined growth and yield traits of wheat were increased with Fe-EDTA applications over control treatment. Among different Fe-EDTA application methods, there was no significant difference for most of the growth and yield parameters (excluding spike length, number of spikelets spike-1, and 1000 grain weight). The amount of Fe in wheat grains was significantly higher in all Fe-EDTA treatments over control, with maximum value (86.54 ± 5.57 mg kg-1) in the treatment where Fe-EDTA was applied in soil + foliar. Similarly, a high Fe build up in surface soil was obtained with treatment of Fe-EDTA in soil + foliar. Overall, with various Fe-EDTA treatments, an increase of 21.2 to 29.1% in grain yield and 1.9 to 4.3 times in Fe concentration of wheat grains was achieved in current study. It is suggested that the Fe should be included in wheat production technology to attain better yield and Fe concentration in grains.

Phosphorus (P) use efficiency is crucial for sustainable wheat production, particularly on alkaline calcareous soils. This study investigates the relative importance of two factors; P acquisition efficiency (PAE) and P utilization efficiency (PUtE), in determining P use efficiency (PUE) in wheat. A field trial with ten wheat genotypes was conducted under two P levels (no P application and P application at 110 kg P2O5 ha−1). Results revealed significant genetic variability in PUE, PAE, and PUtE among wheat genotypes under varying P availabilities. Genotypes MK-4 and MK-8 exhibited superior PUE, making them ideal candidates for soils with differing P levels. PAE played a more substantial role in influencing PUE, with PUtE contributing less to the variability. The findings underscore the importance of improving PAE, particularly for wheat genotypes grown in P-deficient conditions. Moreover, selecting genotypes with lower grain P concentration can enhance PUtE, contributing to improved PUE. These insights can improve breeding efforts and crop management practices to enhance P use efficiency in wheat, ultimately reducing production costs and fertilizer demand, especially in P-limited alkaline calcareous soils.

Abstract Background Go Nisha Go™ (GNG), is a mobile game combining behavioural science, human-centric design, game-based learning, and interactive storytelling. The model uses a direct-to-consumer (DTC) approach to deliver information, products, services, interactive learning, and agency-building experiences directly to girls. The game’s five episodes focus on issues of menstrual health management, fertility awareness, consent, contraception, and negotiation for delay of marriage and career. The game’s effectiveness on indicators linked to these issues will be measured using an encouragement design in a randomized controlled trial (RCT). Methods A two-arm RCT will be conducted in three cities in India: Patna, Jaipur, and Delhi-NCR. The first arm is the treatment (encouragement) arm (n = 975) where the participants will be encouraged to download and play the game, and the second arm (n = 975) where the participants will not receive any nudges/encouragement to play the game. They may or may not have access to the game. After the baseline recruitment, participants will be randomly assigned to these two arms across the three locations. Participants of the treatment/encouragement arm will receive continuous support as part of the encouragement design to adopt, install the game from the Google Play Store at no cost, and play all levels on their Android devices. The encouragement activity will continue for ten weeks, during which participants will receive creative messages via weekly phone calls and WhatsApp messages. We will conduct the follow-up survey with all the participants (n = 1950) from the baseline survey after ten weeks of exposure. We will conduct 60 in-depth qualitative interviews (20 at each location) with a sub-sample of the participants from the encouragement arm to augment the quantitative surveys. Discussion Following pre-testing of survey tools for feasibility of methodologies, we will recruit participants, randomize, collect baseline data, execute the encouragement design, and conduct the follow-up survey with eligible adolescents as written in the study protocol. Our study will add insights for the implementation of an encouragement design in RCTs with adolescent girls in the spectrum of game-based learning on sexual and reproductive health in India. Our study will provide evidence to support the outcome evaluation of the digital mobile game app, GNG. To our knowledge this is the first ever outcome evaluation study for a game-based application, and this study is expected to facilitate scalability of a direct-to-consumer approach to improve adolescent sexual and reproductive health outcomes in India. Trial registration number: ctri.nic.in: CTRI/2023/03/050447.

The international community affirms the critical role of forests in climate change mitigation, which includes reducing emissions from degradation and deforestation, carbon stock conservation, sustainable forest management, and increasing carbon stocks in developing countries. It relates to land use and land cover changes. This study aims to review land use and land cover changes (LULC) in two decades, namely 2000–2010 and 2010–2020, and the impact on carbon stocks. Landsat satellite imagery in 2000, 2010, and 2020 are classified into six categories: built-up area, cropland, forest, water body, bareland, and grassland. This classification uses supervised classification. The accuracy kappa coefficient values obtained for the LULC 2000, LULC 2010, and LULC 2020 maps were 89.61%, 83.90%, and 87.10%, respectively. The most dominant systematic LULC change processes were forest degradation in 2000–2020; the transition of forest to cropland (349.20 ha), forest to bareland (171.19 ha), and forest to built-up area (661.68 ha). Loss of using the forest for other uses was followed by a decrease in carbon stock. There was a high decrease in carbon stock in the forest category (11,000 Mg C∙y–1). The results showed a significant change in land use and cover. The decline in the area occurred in the forest category, which decreased from year to year. Meanwhile, the built-up area increases every year. Carbon stocks also decrease from year to year, especially forests as the most significant carbon store, decreasing in the area.

BackgroundUnderstanding causes and contributors to maternal mortality is critical from a quality improvement perspective to inform decision making and monitor progress toward ending preventable maternal mortality. The indicator "maternal death review coverage" is defined as the percentage of maternal deaths occurring in a facility that are audited. Both the numerator and denominator of this indicator are subject to misclassification errors, underreporting, and bias. This study assessed the validity of the indicator by examining both its numerator-the number and quality of death reviews-and denominator-the number of facility-based maternal deaths and comparing estimates of the indicator obtained from facility- versus district-level data.Methods and findingsWe collected data on the number of maternal deaths and content of death reviews from all health facilities serving as birthing sites in 12 districts in three countries: Argentina, Ghana, and India. Additional data were extracted from health management information systems on the number and dates of maternal deaths and maternal death reviews reported from health facilities to the district-level. We tabulated the percentage of facility deaths with evidence of a review, the percentage of reviews that met the World Health Organization defined standard for maternal and perinatal death surveillance and response. Results were stratified by sociodemographic characteristics of women and facility location and type. We compared these estimates to that obtained using district-level data. and looked at evidence of the review at the district/provincial level. Study teams reviewed facility records at 34 facilities in Argentina, 51 facilities in Ghana, and 282 facilities in India. In total, we found 17 deaths in Argentina, 14 deaths in Ghana, and 58 deaths in India evidenced at facilities. Overall, >80% of deaths had evidence of a review at facilities. In India, a much lower percentage of deaths occurring at secondary-level facilities (61.1%) had evidence of a review compared to deaths in tertiary-level facilities (92.1%). In all three countries, only about half of deaths in each country had complete reviews: 58.8% (n = 10) in Argentina, 57.2% (n = 8) in Ghana, and 41.1% (n = 24) in India. Dramatic reductions in indicator value were seen in several subnational geographic areas, including Gonda and Meerut in India and Sunyani in Ghana. For example, in Gonda only three of the 18 reviews conducted at facilities met the definitional standard (16.7%), which caused the value of the indicator to decrease from 81.8% to 13.6%. Stratification by women's sociodemographic factors suggested systematic differences in completeness of reviews by women's age, place of residence, and timing of death.ConclusionsOur study assessed the validity of an important indicator for ending preventable deaths: the coverage of reviews of maternal deaths occurring in facilities in three study settings. We found discrepancies in deaths recorded at facilities and those reported to districts from facilities. Further, few maternal death reviews met global quality standards for completeness. The value of the calculated indicator masked inaccuracies in counts of both deaths and reviews and gave no indication of completeness, thus undermining the ultimate utility of the measure in achieving an accurate measure of coverage.

Abstract Background Despite the unprecedented impact of COVID-19 on the food supply chain since 2020. Understanding the current trends of research and scenarios in the food supply chain is critical for developing effective strategies to address the present issue. This study aims to provide comprehensive insights into the pre, during, and post COVID-19 pandemic in the food supply chain. Methodology This study used the Scopus database from 1995 to November 6, 2022, to analyse the food supply chain. Bibliometric analysis was conducted using VOSviewer software to create knowledge maps and visualizations for co-occurrence, co-authorship, and country collaboration. Biblioshiny, a shiny app for the Bibliometrix R package, was then used to explore theme evaluation path maps in the research domain. Results The bibliometric analysis of 2523 documents provides important insights into present and future publication trends. Top author keywords included blockchain, traceability, food safety, sustainability, and supply chain management. The Sustainability (Switzerland) journal ranked first in productivity, and the International Journal of Production Economics received the highest citations. The United Kingdom was the most productive country, collaborating with partners in Europe, Asia, and North America. The Netherlands had the highest percentage of documents with international authors, while India and China had the lowest. The thematic evaluation maps revealed that articles focused on important research topics including food processing industry, information sharing, risk assessment, decision-making, biodiversity, food safety, and food waste. Conclusion This study contribute to the growing body of literature on the food supply chain by providing a comprehensive analysis of research trends during different phases of the pandemic. The findings can be used to inform policymakers and industry leaders about the measures required to build a more resilient and sustainable food supply chain infrastructure for the future. This study considered only Scopus online database for bibliometric analysis, which may have limited the search strategy. Future studies are encouraged to consider related published articles by linking multiple databases.

In connection with the development plan of the USK campus II area, it is necessary to map the area to support and complete the necessary data. Mapping with an Unmanned Aerial Vehicle (UAV) is a strategy or way for large-scale mapping with a faster and more efficient time. It can save time compared to using conventional survey methods. Ground Control Point (GCP) measurements are carried out with geodetic GNSS to improve the accuracy/correction of the geometry of the aerial portrait results. This research aims to provide preliminary information about the topographic conditions and current appearance of the USK campus II development location. The results of the aerial photo research with a spatial resolution of 5 cm/pixel show that most of the area looks green, which is a forest area. Some areas in the west and north, such as in the rectorate block, are C excavation mining areas. Based on contour data in the USK II area, the PON block's ground elevation is 66 to 301 meters, in the faculty block, 50 to 260 meters, and in the rectorate block, 90 to 188 meters.

Depleting soil fertility and low fertilizer efficiency in alkaline calcareous soils are serious issues worldwide creating an immediate threat to environment and food security. Integrated nutrient management (INM) can be a promising eco-friendly strategy for improving crop performance and resource efficiency to resolve these concerns. A field study was conducted to investigate the integrated effect of organic sources [farm yard manure (FYM) @ 10 tons ha-1 and press mud (PM) @ 5 tons ha-1] along with various NPK rates [100, 75, 50% recommended dose of fertilizer (RDF)] on root system, nutrient efficiency, and yield of wheat cultivar Kiran-95. Longest roots were measured in FYM + RDF50 while highest surface area and number of root tips were recorded in PM + RDF50 than RDF alone. However, maximum root volume and average root diameter was observed in PM + RDF100 and PM + RDF75, respectively compared with RDF only. PM + RDF100 considerably enhanced grain yield and related traits i.e., spike length, tillers count m-2 and 100-grain weight as compared to RDF only. Integration of PM and 100% RDF showed higher NPK uptake, than RDF alone. Recovery efficiency (RE) of NPK was calculated higher at lower fertilizer rates and vice versa. The sole application of RDF100 showed least RE of NPK whilst PM + RDF50 revealed higher RE of NPK. The results suggested that INM could be a sustainable approach to enhance wheat productivity and nutrient efficiency in alkaline calcareous soils. In addition, PM along with RDF100 NPK fertilizers proved superior in improving root traits and nutrient accumulation thereby increasing wheat grain yield.

This paper aims to describe the research results in the form of the effectiveness of the implementation of PT. Semen Padang in its Corporate Social Responsibility Program (CSR). Furthermore, the researcher describes the point of the performance of the CSR program PT. Semen Padang in Batu Gadang Urban Village. Moreover, this study aims to determine the implementation barriers the stakeholders faced and efforts to overcome the obstacles that hinder the effectiveness of the implementation of the CSR program of PT. Semen Padang. This study uses a qualitative approach with a descriptive method. Data was collected using observation, interviews, and documentation studies. In the findings of this study, it can be observed that the effectiveness of the implementation of the CSR program of PT. Semen Padang has an impact on the community empowerment process. This paper also explains that the data on potential beneficiaries of the program has not been consolidated; this has led to a double check by the Nagari Forum in identifying beneficiaries of the CSR program of PT. Semen Padang. Especially with the public’s understanding of the CSR program of PT. Semen Padang is still low, making the activities of this company become constrained in its implementation.

OBJECTIVES To determine the effect of pyeloplasty on renal cortical thickness in the pediatric population with ureteropelvic junction obstruction (UPJO). METHODOLOGY This retrospective study examined the renal cortical thickness in 100 pediatric patients diagnosed with ureteropelvic junction obstruction (UPJO). The study employed a non-probability consecutive sampling technique to select participants. Inclusion criteria encompassed children below five years of age, of both genders, with Pakistani nationality, and availability of both pre-and post-operative ultrasound data. Cases presenting with ureterovesical junction obstruction or vesicoureteral reflux were excluded from the analysis. Data collection involved gathering information on age, gender, and cortical thickness, with renal cortical thickness assessed through ultrasonography. A paired t-test was employed to compare the renal cortical thickness between the preoperative assessment and the 3-month follow-up. RESULTS The females were 40(40%) and males were 60(60%). The mean age was 33.51±22.91months. The mean cortical thickness before pyeloplasty was 5.23±0.93mm and 8.25 ± 2.34mm after pyeloplasty. The renal cortical thickness in both genders significantly increased to 3mm (p

Abstract Background In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India. Methods A nationally representative data of adolescents (10–19 years) from the Comprehensive National Nutrition Survey was used. MS was defined based on the NCEP–ATP III criteria for adolescents. Bivariate analysis was used to report socio-demographic differentials in prevalence and to assess interstate variability. Multivariate logistic regression model was constructed to measure the association between socio-demographic characteristics and prevalence of MS. Census data from 2011 was projected to 2017 to calculate burden. Results The prevalence of MS was 5.2% among adolescents. 11.9%, 15.4%, 26.0%, 31.9% and 3.7% had central obesity, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, respectively. The prevalence was higher among males (5.7% vs. 4.7%, adjusted odds ratio (AOR): 1.3, 95% confidence interval [CI]: 1.0, 1.6), those residing in urban areas (7.9% vs 4.2%, AOR: 1.4, 95% CI: 1.1, 1.8), and from wealthier households as compared to their counterparts (8.3% vs. 2.4%, AOR: 3.4, 95% CI: 2.1, 5.5). There was wide interstate variability in the prevalence of MS (0.5% – 16.5%). In 2017, 14.2 million adolescents had MS in India. Conclusions The prevalence of MS among adolescents in India is low and clustered in urban areas and richer households. Early prevention interventions promoting a healthy lifestyle, especially in high prevalence areas, are needed to keep MS from becoming a public health issue.

Background: Nonmedical use of prescription drugs for recreational purposes is a major health problem that raises high concerns for public health. Recently, several laboratory studies have reported the misuse of pentazocine, an agonist-antagonist opioid in combination with antihistamines in opioid addicts. Illicit self administration of prescription drugs has been increasingly reported in India. Urinalysis as an adjunct to self report plays a key role in providing additional information in the treatment of drug users. This paper aims to discuss a simple, convenient, and rapid capillary column gas-liquid chromatography method for simultaneous detection of pentazocine, pheniramine, and cotinine in urine.Methods: The sample was extracted with chloroform and isopropanol (3:1,v/v) and evaporated to dryness. After reconstitution with methanol, it was directly subjected to gas chromatography analysis. Method performance was evaluated and validated in terms of sensitivity, precision, the limit of detection (LOD), and the limit of quantification (LOQ).Findings: The linearity obtained was in the range of 50–1000 ng/ml with a correlation coefficient (r) above 0.999 for each drug. Good LOQ (50ng/ml) was obtained with each drug. Also, the developed method was effective in analyzing samples from patients with suspected abuse of these drugs.Conclusion: The technique was found to be simple, robust, sensitive, and precise in the simultaneous analysis of drugs (pentazocine, pheniramine, and cotinine). This method was proved to be useful and cost-effective in treating and monitoring patients seeking help for addiction in clinical settings.

Background: Peripheral artery disease (PAD) is highly prevalent in patients with diabetes mellitus. The ankle-brachial index (ABI) measurement is used to diagnose peripheral arterial disease, and little is known about its prevalence in asymptomatic type 2 Diabetic patients. This study aimed to determine the prevalence of subclinical peripheral artery disease in patients with type II diabetes mellitus. Methodology: It was a descriptive study conducted at the Peshawar Institute of Medical Sciences, from Feb 2022 to Aug 2022. Two hundred sixty-four patients with type II diabetes (for more than three years) with no clinical features of peripheral arterial disease were assessed by measuring ankle brachial pressure index for subclinical peripheral arterial disease. Reading less than 0.9 was positive for peripheral artery disease in the lower limbs. Results: Peripheral Arterial Disease was present in 115 (43.6%) patients and absent in 149 (56.4%) patients. The peripheral artery disease was significantly more in males, those with age greater than 55 years, smokers, and hypertensive patients (p-value ≤ 0.05) but was not associated with the duration of diabetes or BMI of the patient (p-value > 0.05) Conclusion: There was a high prevalence of asymptomatic peripheral artery disease in Type 2 Diabetic patients using ankle-brachial pressure index measurement. Those with ages greater than 55 years, smokers, hypertensive, and males were particularly at higher risk.

Objetivo: Examinar la correspondencia entre la relación plaquetas-linfocitos (RPL) y los puntajes GRACE y TIMI en pacientes con síndrome coronario agudo. Materiales y método: Se incluyeron 1.000 pacientes con síndrome coronario agudo que fueron asignados al Departamento de Cardiología del Dustira Army Hospital. El examen del paciente y el registro médico se realizaron entre enero del 2019 y junio del 2020. Resultados: El puntaje de riesgo GRACE fue sustancialmente mayor en el grupo de RPL alta en comparación con los grupos de RPL moderada y baja [158 (144-174), 130 (114.5-149) y 124 (104-147.75)], respectivamente (p < 0.000). De manera similar, el grupo de RPL alta tuvo puntajes TIMI significativamente más altos para angina inestable, infarto de miocardio sin elevación del segmento ST (IAMSEST) e infarto agudo de miocardio con elevación del segmento ST (IAMCEST) que los grupos de RPL moderada y baja [3 (3-4), 3 (3-4), 3 (3-3), p = 0.001; 5 (4-5), 4 (4-5), 4.5 (4-5), p < 0.000 y 6 (5-7), 6 (5-6), 6 (5.5-6), p = 0.003]. Además, los puntajes de riesgo GRACE (r = 0,314, p < 0,000), TIMI para AI (r = 0.365, p < 0.000), TIMI para IAMSEST (r = 0.314, p = 0.001) y TIMI para IAMCEST (r = 0.227, p = 0.001) también tenían un vínculo favorable con la RPL. Conclusión: La RPL es un marcador de laboratorio económico, conveniente y reproducible en la práctica clínica habitual, que podría predecir el pronóstico en pacientes con síndrome coronario agudo.

BackgroundIntegrating measures of respectful care is an important priority in family planning programs, aligned with maternal health efforts. Ensuring women can make autonomous reproductive health decisions is an important indicator of respectful care. While scales have been developed and validated in family planning for dimensions of person-centered care, none focus specifically on decision-making autonomy. The Mothers Autonomy in Decision-Making (MADM) scale measures autonomy in decision-making during maternity care. We adapted the MADM scale to measure autonomy surrounding a woman's decision to use a contraceptive method within the context of contraceptive counselling. This study presents a psychometric validation of the Family Planning Autonomous Decision-Making (FP-ADM) scale using data from Argentina, Ghana, and India.Methods and findingsWe used cross-sectional data from women in four subnational areas in Argentina (n = 890), Ghana (n = 1,114), and India (n = 1,130). In each area, 20 primary sampling units (PSUs) were randomly selected based on probability proportional to size. Households were randomly selected in Ghana and India. In Argentina, all facilities providing reproductive and maternal health services within selected PSUs were included and women were randomly selected upon exiting the facility. Interviews were conducted with a sample of 360 women per district. In total, 890 women completed the FP-ADM in Argentina, 1,114 in Ghana and 1,130 in India. To measure autonomous decision-making within FP service delivery, we adapted the items of the MADM scale to focus on family planning. To assess the scale's psychometric properties, we first examined the eigenvalues and conducted a parallel analysis to determine the number of factors. We then conducted exploratory factor analysis to determine which items to retain. The resulting factors were then identified based on the corresponding items. Internal consistency reliability was assessed with Cronbach's alpha. We assessed both convergent and divergent construct validity by examining associations with expected outcomes related to the underlying construct. The Eigenvalues and parallel analysis suggested a two-factor solution. The two underlying dimensions of the construct were identified as "Bidirectional Exchange of Information" (Factor 1) and "Empowered Choice" (Factor 2). Cronbach's alpha was calculated for the full scale and each subscale. Results suggested good internal consistency of the scale. There was a strong, significant positive association between whether a woman expressed satisfaction with quality of care received from the healthcare provider and her FP-ADM score in all three countries and a significant negative association between a woman's FP-ADM score and her stated desire to switch contraceptive methods in the future.ConclusionsOur results suggest the FP-ADM is a valid instrument to assess decision-making autonomy in contraceptive counseling and service delivery in diverse low- and middle-income countries. The scale evidenced strong construct, convergent, and divergent validity and high internal consistency reliability. Use of the FP-ADM scale could contribute to improved measurement of person-centered family planning services.

Availability of emergency obstetric and newborn care (EmONC) is a strong supply side measure of essential health system capacity that is closely and causally linked to maternal mortality reduction and fundamentally to achieving universal health coverage. The World Health Organization's indicator "Availability of EmONC facilities" was prioritized as a core indicator to prevent maternal death. The indicator focuses on whether there are sufficient emergency care facilities to meet the population need, but not all facilities designated as providing EmONC function as such. This study seeks to validate "Availability of EmONC" by comparing the value of the indicator after accounting for key aspects of facility functionality and an alternative measure of geographic distribution. This study takes place in four subnational geographic areas in Argentina, Ghana, and India using a census of all birthing facilities. Performance of EmONC in the 90 days prior to data collection was assessed by examining facility records. Data were collected on facility operating hours, staffing, and availability of essential medications. Population estimates were generated using ArcGIS software using WorldPop to estimate the total population, and the number of women of reproductive age (WRA), pregnancies and births in the study areas. In addition, we estimated the population within two-hours travel time of an EmONC facility by incorporating data on terrain from Open Street Map. Using these data sources, we calculated and compared the value of the indicator after incorporating data on facility performance and functionality while varying the reference population used. Further, we compared its value to the proportion of the population within two-hours travel time of an EmONC facility. Included in our study were 34 birthing facilities in Argentina, 51 in Ghana, and 282 in India. Facility performance of basic EmONC (BEmONC) and comprehensive EmONC (CEmONC) signal functions varied considerably. One facility (4.8%) in Ghana and no facility in India designated as BEmONC had performed all seven BEmONC signal functions. In Argentina, three (8.8%) CEmONC-designated facilities performed all nine CEmONC signal functions, all located in Buenos Aires Region V. Four CEmONC-designated facilities in Ghana (57.1%) and the three CEmONC-designated facilities in India (23.1%) evidenced full CEmONC performance. No sub-national study area in Argentina or India reached the target of 5 BEmONC-level facilities per 20,000 births after incorporating facility functionality yet 100% did in Argentina and 50% did in India when considering only facility designation. Demographic differences also accounted for important variation in the indicator's value. In Ghana, the total population in Tolon within 2 hours travel time of a designated EmONC facility was estimated at 99.6%; however, only 91.1% of women of reproductive age were within 2 hours travel time. Comparing the value of the indicator when calculated using different definitions reveals important inconsistencies, resulting in conflicting information about whether the threshold for sufficient coverage is met. This raises important questions related to the indicator's validity. To provide a valid measure of effective coverage of EmONC, the construct for measurement should extend beyond the most narrow definition of availability and account for functionality and geographic accessibility.

BackgroundThere is a global shortage of midwives, whose services are essential to meet the healthcare needs of pregnant women and newborns. Evidence suggests that if enough midwives, trained and regulated to global standards, were deployed worldwide, maternal, and perinatal mortality would decline significantly. Health workforce planning estimates the number of midwives needed to achieve population coverage of midwifery interventions. However, to provide a valid measure of midwifery care coverage, an indicator must consider not only the raw number of midwives, but also their scope and competency. The tasks midwives are authorized to deliver and their competency to perform essential skills and behaviors provide crucial information for understanding the availability of safe, high-quality midwifery services. Without reliable estimates for an adequate midwifery workforce, progress toward ending preventable maternal and perinatal mortality will continue to be uneven. The International Labor Organization (ILO) and the International Confederation of Midwives (ICM) suggest standards for midwifery scope of practice and competencies. This paper compares national midwifery regulations, scope, and competencies in three countries to the ILO and ICM standards to validate measures of midwife density. We also assess midwives' self-reported skills/behaviors from the ICM competencies and their acquisition.Methods and findingsWe compared midwives' scope of practice in Argentina, Ghana, and India to the ILO Tasks and ICM Essential Competencies for Midwifery Practice. We compared midwives self-reported skills/behaviors with the ICM Competencies. Univariate and bivariate analysis was conducted to describe the association between midwives' skills and selected characteristics. National scopes of practice matched two ILO tasks in Argentina, four in India, and all in Ghana. National standards partially reflected ICM skills in Categories 2, 3, and 4 (pre-pregnancy and antenatal care; care during labor and birth; and ongoing care of women and newborns, respectively) in Argentina (range 11% to 67%), mostly in India (range 74% to 100%) and completely in Ghana (100% match). 1,266 midwives surveyed reported considerable variation in competency for skills and behaviors across ICM Category 2, 3, and 4. Most midwives reported matching skills and behaviors around labor and childbirth (Category 2). Higher proportions of midwives reported gaining basic skills through in-service training and on-job-experience than in pre-service training.ConclusionEstimating the density of midwives needed for an adequate midwifery workforce capable of providing effective population coverage is predicated on a valid numerator. A reliable and valid count of midwives to meet population needs assumes that each midwife counted has the authority to exercise the same behaviors and reflects the ability to perform them with comparable competency. Our results demonstrate variation in midwifery scopes of practice and self-reported competencies in comparison to global standards that pose a threat to the reliability and validity of the numerator in measures of midwife density, and suggest the potential for expanded authorization and improved education and training to meet global reference standards for midwifery practice has not been fully realized. Although the universally recognized standard, this study demonstrates that the complex, composite descriptions of skills and behaviors in the ICM competencies make them difficult to use as benchmark measures with any precision, as they are not defined or structured to serve as valid measures for assessing workforce competency. A simplified, content-validated measurement system is needed to facilitate evaluation of the competency of the midwifery workforce.

BackgroundMidwives' authorization to deliver the seven basic emergency obstetric and newborn care (BEmONC) functions is a core policy indicator in global monitoring frameworks, yet little evidence supports whether such data are captured accurately, or whether authorization demonstrates convergence with midwives' skills and actual provision of services. In this study, we aimed to validate the data reported in global monitoring frameworks (criterion validity) and to determine whether a measure of authorization is a valid indicator for BEmONC availability (construct validity).MethodsWe conducted a validation study in Argentina, Ghana, and India. To assess accuracy of the reported data on midwives' authorization to provide BEmONC services, we reviewed national regulatory documents and compared with reported country-specific data in Countdown to 2030 and the World Health Organization Maternal, Newborn, Child and Adolescent Health Policy Survey. To assess whether authorization demonstrates convergent validity with midwives' skills, training, and performance of BEmONC signal functions, we surveyed 1257 midwives/midwifery professionals and assessed variance.ResultsWe detected discrepancies between data reported in the global monitoring frameworks and the national regulatory framework in all three countries. We found wide variations between midwives' authorization to perform signal functions and their self-reported skills and actual performance within the past 90 days. The percentage of midwives who reported performing all signal functions for which they were authorized per country-specific regulations was 17% in Argentina, 23% in Ghana, and 31% in India. Additionally, midwives in all three countries reported performing some signal functions that the national regulations did not authorize.ConclusionOur findings suggest limitations in criterion and construct validity for this indicator in Argentina, Ghana, and India. Some signal functions such as assisted vaginal delivery may be obsolete based on current practice patterns. Findings suggest the need to re-examine the emergency interventions that should be included as BEmONC signal functions.

BackgroundA global midwifery shortage hampers the goal of ending preventable maternal/newborn mortality and stillbirths. Whether current measures of midwifery workforce adequacy are valid is unknown. We compare two measures of density and distribution of midwifery professionals to assess their consistency, and explore how incorporating midwifery scope, competency, and the adjusting reference population impacts this critical metric.Methods and findingsWe collected a census of midwives employed in eligible facilities in our study settings, (422 in Ghana; 909 in India), assessed the number practicing within the scope of work for midwifery professionals defined in the International Labor Organization International Standard Classification of Occupations, and whether they reported possessing the ICM essential competencies for basic midwifery practice. We altered the numerator, iteratively narrowing it from a simple count to include data on scope of practice and competency and reported changes in value. We altered the denominator by calculating the number of midwives per 10,000 total population, women of reproductive age, pregnancies, and births and explored variation in the indicator. Across four districts in Ghana, density of midwives decreased from 8.59/10,000 total population when counting midwives from facility staffing rosters to 1.30/10,000 total population when including only fully competent midwives by the ICM standard. In India, no midwives met the standard, thus the midwifery density of 1.37/10,000 total population from staffing rosters reduced to 0.00 considering competency. Changing the denominator to births vastly altered subnational measures, ranging from ~1700% change in Tolon to ~8700% in Thiruvallur.ConclusionOur study shows that varying underlying parameters significantly affects the value of the estimate. Factoring in competency greatly impacts the effective coverage of midwifery professionals. Disproportionate differences were noted when need was estimated based on total population versus births. Future research should compare various estimates of midwifery density to health system process and outcome measures.

Abstrak. Sempadan sungai merupakan kawasan penyangga antara ekosistem perairan (sungai) dan daratan. Sungai Krueng Lamnyong terletak di Kota Banda Aceh dan Kabupaten Aceh Besar yang merupakan daerah hilir dari sungai Krueng Aceh. Sempadan sungai Krueng Lamnyong telah dimanfaatkan oleh berbagai pihak untuk berbagai peruntukan. Penelitian ini bertujuan untuk mengevaluasi kesesuaian peruntukan lahan sempadan sungai Krueng Lamnyong berdasarkan peraturan perundang-undangan. Identifikasi serta evaluasi peruntukan lahan di sempadan sungai Krueng Lamnyong menggunakan perangkat lunak Sistem Informasi Geografis (SIG). Hasil penelitian menunjukkan bahwa penggunaan sempadan sungai Krueng Lamnyong diperoleh 10 jenis penggunaan lahan. Penggunaan sempadan sungai Krueng Lamnyong yang teridentifikasi sesuai dengan peruntukan yaitu sebesar 110,91 Ha atau 68,13% yang terdiri dari irigasi, jalan, sawah, rerumputan, tanaman palawija dan tanah kosong. Penggunaan yang tidak sesuai peruntukan sebesar 51,88 Ha atau 31,87% yang terdiri dari ruang terbangun, kebun, vegetasi mangrove dan kanopi pohon. Evaluation of Land Use Suitability in Aceh Province's Krueng Lamnyong River Border Abstract. The river border is a buffer area between aquatic ecosystems (rivers) and land. The Krueng Lamnyong River is located in Banda Aceh City and Aceh Besar District which is the downstream area of the Krueng Aceh river. The Krueng Lamnyong river border has been used by various parties for various purposes. This study aims to evaluate the suitability of the land use of the Krueng Lamnyong river border based on the legislation. Identification and evaluation of land use in the Krueng Lamnyong river border using Geographic Information System (GIS) software. The results showed that the use of the Krueng Lamnyong river border obtain 10 types of land use. The use of the Krueng Lamnyong river border identified according to its designation is 110.91 Ha or 68.13% consisting of irrigation, roads, rice fields, grass, crops, and vacant land. The use that is not in accordance with the designation is 51.88 Ha or 31.87% consisting of build space, gardens, mangrove vegetation, and tree canopies.

Abstract Background The ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation and Attention for Learning) theory of motor learning suggests that autonomy, external focus of attention, and perceived competence can improve learning of simple motor tasks. The authors hypothesized that enhanced (vs. routine) autonomy and external (vs. internal) focus of attention would improve first-try performance of two medical motor tasks. Methods The authors conducted a randomized two-by-two factorial design study with high school students as participants. Task instructions promoted either enhanced or routine autonomy, and either external or internal focus of attention. These conditions were replicated in a crossover design for two common medical tasks (chest compressions on a manikin and a Fundamentals of Laparoscopic Surgery peg transfer task). Primary outcomes were objective measures of task performance (chest compression deviation from target depth; peg transfer time with penalties for errors). Secondary outcomes included subjective perceptions of confidence, autonomy, and workload. Results One hundred thirty-three high school students participated in this study. The primary outcomes concerning enhanced vs. routine autonomy demonstrated no statistically significant difference in either task (chest compression depth deviation: difference -0.7 mm [score range 0 to 37.5 mm]; 95% confidence interval (CI95) -3.85, 2.41; p = .65; peg transfer penalized time: rate ratio 1.03; CI95 0.91, 1.31; p = .79). The authors likewise found no statistically significant difference for external vs. internal focus of attention (depth deviation: difference 1.1 mm; CI95 -2.04, 4.17; p = .50; penalized time: rate ratio 0.89; CI95 0.75, 1.13; p = .33). The authors found no statistically significant differences for either comparison in confidence, autonomy and workload (p > .09; differences ranged from -0.83 to 0.79 [scale range 0 to 10]). Conclusions First-try performance of chest compressions and peg transfer by novice learners is not significantly affected by enhanced (vs. routine) autonomy or external (vs. internal) focus of attention.

Cardiovascular disease has shown a profound increase year by year which leading cause of death globally, accounts for 38 million people each year for mortality with almost three-quarters of deaths occurring in lower-middle countries. In 2014 US army statistics shown 9.4% of army personnel had cardiovascular disease, compared to 6.8% in 2007. The aims of this study are to provide an overview of cardiovascular disease in military personnel, risk factors obtained in military personnel, and preventive measures taken to reduce the progression of cardiovascular disease. It was Descriptive Observational Study with focus in literature study. The data was collected by literature with associated in military morbidities, military cardiovascular factor and preventive health. Cardiovascular risk factors could be the important point to intervene to gain more benefits that could ameliorate the progression of cardiovascular disease. Many factors that influence Military personnel include strategic factors, external and internal factors that could contribute to the health condition. Preventive health is very important to improve the health condition of military personnel considering that various deadly diseases like cardiovascular disease can be prevented through preventive health activities, so the fatal consequences and loss of life and large assets can be eliminated or at least minimized. There are various efforts to improve the implementation of preventive health development, including intensive health education socialization, Military routine health check-ups as screening, military hospital big data as basis data, and military personal handbook. Programs for the implementation of preventive health development could be run with obligation from Higher Military Office.

Abstract Objective Nationally representative percentiles for waist circumference (WC), waist‐to‐height‐ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India. Methods Using LMS method, age‐ and gender‐specific reference growth charts were constructed for WC (n = 68,261), WHtR (n = 68,261), and BMI (n = 67,741) from children/adolescents aged 5–19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age–sex‐specific BMI z‐scores ≥ 95th percentile. Central obesity was defined in three ways: WC ≥ 90th percentile, WHtR ≥ 0.5, and both WC ≥ 90th percentile and WHtR ≥ 0.5. Findings WC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2.9% (95% CI: 2.6–3.2). The prevalence of central obesity was 6.1% (95% CI: 5.7–6.6) using WC ≥ 90th percentile, 5.3% (95% CI: 5.0–5.7) using WHtR ≥ 0.5, and 3.6% using both criteria. Three‐fourth of children with general obesity also had central obesity based on WC ≥ 90th. Conclusions Indian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity with a significant overlap between the two.

Abstract Background Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF. Methods The present study used data of 38,060 children under the age of five years and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey of children and adolescents aged 0–19 years in India. The CIAF outcome variable in this study provide an overall prevalence of undernutrition, with six mutually exclusive anthropometric measurements of height-for-age, height-for-weight, and weight-for-age, calculated using the World Health Organization (WHO) Multicenter Growth Reference Study. Multivariate regression and decomposition analysis were used to examine the association between covariates with CIAF and to estimate the contribution of different covariates in the existing rich-poor gap. Results An overall CIAF prevalence of 48.2% among children aged aged under 5 years of age was found in this study. 6.0% children had all three forms of anthropometric failures. The odds of CIAF were more likely among children belonging to poorest households (AOR: 2.41, 95% CI: 2.12–2.75) and those residing in urban area (AOR: 1.06, 95% CI 1.00–1.11). Children of underweight mothers and those with high parity were at higher risk of CIAF (AOR: 1.51, 95% CI: 1.42–1.61) and (AOR: 1.15, 95% CI: 1.08–1.22), respectively. Children of mother exposed to mass media were at lower risk of CIAF (AOR: 0.87, 95% CI: 0.81–0.93). Conclusion This study estimated a composite index to assess the overall anthropometric failure, which also provides a broader understanding of the extent and pattern of undernutrition among children. Findings show that maternal covariates contribute the most to the rich-poor gap. As well, the findings suggest that intervention programs with a targeted approach are crucial to reach the most vulnerable groups and to reduce the overall burden of undernutrition.

Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of Echinococcus granulosus tapeworms. These parasites have a worldwide geographic distribution and pose a serious threat to livestock industry as well as human health in the endemic areas. CE is widely distributed in Pakistan. However, very few reports are available related to the regional transmission of E. granulosus. A retrospective analysis was conducted of surgically confirmed CE patients who were treated at Shoukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Punjab Province, Pakistan from 2007 – 2018. In total, 536 CE patients were evaluated during the study period. Cases originated from the provinces of Khyber Pakhtunkhwa (n=336), Punjab (n=147), Baluchistan (n=18), Sindh (n=3), Islamabad (n=2), Gilgit Baltistan (n=1), and Azad Jammu and Kashmir (n=1). An additional 28 cases were from Afghanistan. The highest number of CE cases was reported in 2013 (n=90). Females made up a larger proportion of cases (n=310; 57.8 %) than males (n=226; 42.2 %). Most patients were members of the Pashtun (n=197; 36.7 %), Hindku (n=142; 26.5 %), and Punjabi (n=118; 22.0 %) ethnic groups. The largest number of cysts was obtained from the liver (137/536; 25.6 %). This study showed that CE is likely present throughout Pakistan. In order to control the disease, a comprehensive control program and regional surveillance are needed.

A sensitive electroactive platform relies directly upon the efficient and conductive interface. This work offers a simple and effective method for synthesizing NiCo2O4 using CTAB surfactant, suited for trace-level antibiotic detection. The route realized the controlled growth of tiny NiCo2O4 nanoboulders with an exposed interface. A comparative evaluation of the bimetallic nanostructures with their pristine compositional counterparts, i.e., NiO and Co3O4, supports its superior electrochemical characteristics based on the synergism of strong redox activity and conductivity from the bimetallic components. The NiCo2O4 nanoboulders exhibited strong electrochemical activity when configured as electrode material for detecting ofloxacin (OFL), a common antibiotic. The sensor exhibited excellent working linearity in a low-concentration range of 0.01–5 ​μM with a detection limit of 1 ​× ​10−3 ​μM for OFL. The kinetics of the NiCo2O4 further supported the electrocatalytic oxidation of OFL to be diffusion controlled with an estimated diffusion coefficient of 2.03310−6 ​cm2 ​s−1. Moreover, the constructed sensor is applicable for detecting OFL from environmental samples, reflecting its workability in complex real-environment.

Background The stability of biological samples is vital for reliable measurements of biomarkers in large-scale survey settings, which may be affected by freeze-thaw procedures. We examined the effect of a single freeze-thaw cycle on 13 nutritional, noncommunicable diseases (NCD), and inflammatory bioanalytes in serum samples. Method Blood samples were collected from 70 subjects centrifuged after 30 minutes and aliquoted immediately. After a baseline analysis of the analytes, the samples were stored at − 70°C for 1 month and reanalyzed for all the parameters. Mean percentage differences between baseline (fresh blood) and freeze-thaw concentrations were calculated using paired sample t-tests and evaluated according to total allowable error (TEa) limits (desirable bias). Results Freeze-thaw concentrations differed significantly (p < 0.05) from baseline concentrations for soluble transferrin receptor (sTfR) (− 5.49%), vitamin D (− 12.51%), vitamin B12 (− 3.74%), plasma glucose (1.93%), C-reactive protein (CRP) (3.45%), high-density lipoprotein (HDL) (7.98%), and cholesterol (9.76%), but they were within respective TEa limits. Low-density lipoprotein (LDL) (− 0.67%), creatinine (0.94%), albumin (0.87%), total protein (1.00%), ferritin (− 0.58%), and triglycerides (TAG) (2.82%) concentrations remained stable following the freeze-thaw cycle. In conclusion, single freeze-thaw cycle of the biomarkers in serum/plasma samples after storage at − 70°C for 1 month had minimal effect on stability of the studied analytes, and the changes in concentration were within acceptable limit for all analytes.

Sheikh Nizamuddin,1,2 Shivendra Dubey,1 Sakshi Singh,1 Saurav Sharma1 ,† Pratheusa Machha,1,3 Kumarasamy Thangaraj1,3,4 1CSIR-Centre for Cellular and Molecular Biology, Hyderabad 500007, India; 2German Cancer Consortium (DKTK) c/o Zentrale Klinische Forschung (ZKF), University Medical Center, Freiburg, Germany; 3AcSIR (Academy of Scientific and Innovative Research), CSIR-Centre for Cellular and Molecular Biology, Hyderabad 500007, India; 4DBT-Centre for DNA Fingerprinting and Diagnostics, Hyderabad 500039, India†Mr Sharma passed away on June 11, 2019.Correspondence: Kumarasamy ThangarajCSIR-Centre for Cellular and Molecular Biology, Hyderabad, Telangana 500007, IndiaFax +91-40-27160311Email thangs@ccmb.res.inIntroduction: Allelic frequency distribution of drug metabolizing enzyme genes among populations is important to identify risk groups for adverse drug reaction and to select representative populations for clinical trials. Although India emerged as an important hub for clinical trials, information about the pharmacogenetic diversity for this region is still lacking. Here, we investigated genetic diversity of cytochrome-P450-2C9 (CYP2C9) gene which metabolizes wide range of drugs and is highly expressed in the human liver.Methods: In total, 1278 individuals from 36 diverse Indian populations, 210 individuals from in-house data-repository and 489 other South Asian samples from the 1000 Genomes Project were selected. Variants observed in CYP2C9 gene were subjected to various statistical analyses.Results: High frequency of CYP2C9*3 (∼ 13%) and CYP2C9*3/*3 (∼ 1%) was observed among South Asians, compared to 21 populations living outside the Indian subcontinent. The allelic/genotypic frequency does not correlate with geographical location or linguistic affiliation, except populations speaking Tibeto-Burmans language, who have lower frequency of CYP2C9*3 and CYP2C9*3/*3. Since, South Asians practice strict endogamy, presence of unique mutation and high frequency of homozygous genotypes not surprising. CYP2C9*3 has been associated with therapeutic response.The effect of CYP2C9*3/*3 is more pronounced compared to heterozygous and wild type homozygous genotypes as evident in many in vitro studies. As South Asians have high frequency, it would be interesting to explore potential of CYP2C9*3 as a marker for personalized therapy. Our study revealed several rare functional variants, which form eight novel and rare haplotypes of CYP2C9 (CYP2C9*63–*70). Of which, CYP2C9*64, *65, *66, *68, *69 and *70 haplotypes are South Asian-specific.Conclusion: Overall, we find high genetic heterogeneity within South Asians and identified South Asian-specific putative functional CYP2C9 haplotypes. High frequency of CYP2C9*3 and CYP2C9*3/*3 was observed in South Asian populations. Taken together, current study greatly enriches the knowledge of naturally occurring CYP2C9 variants and its diversity in South Asia, which are relevant to further CYP2C9-related functional research and for personalized medicine.Keywords: pharmacogenetics, CYP2C9, South Asians, genetic diversity

Catastrophic natural hazards, such as earthquake, pose serious threats to properties and human lives in urban areas. Therefore, earthquake risk assessment (ERA) is indispensable in disaster management. ERA is an integration of the extent of probability and vulnerability of assets. This study develops an integrated model by using the artificial neural network–analytic hierarchy process (ANN–AHP) model for constructing the ERA map. The aim of the study is to quantify urban population risk that may be caused by impending earthquakes. The model is applied to the city of Banda Aceh in Indonesia, a seismically active zone of Aceh province frequently affected by devastating earthquakes. ANN is used for probability mapping, whereas AHP is used to assess urban vulnerability after the hazard map is created with the aid of earthquake intensity variation thematic layering. The risk map is subsequently created by combining the probability, hazard, and vulnerability maps. Then, the risk levels of various zones are obtained. The validation process reveals that the proposed model can map the earthquake probability based on historical events with an accuracy of 84%. Furthermore, results show that the central and southeastern regions of the city have moderate to very high risk classifications, whereas the other parts of the city fall under low to very low earthquake risk classifications. The findings of this research are useful for government agencies and decision makers, particularly in estimating risk dimensions in urban areas and for the future studies to project the preparedness strategies for Banda Aceh. Keywords: Earthquake, Hazard, Vulnerability, Risk, GIS, ANN–AHP

This paper presents the design and implementation of proportional integral derivative (PID) structured centralized and decentralized automatic generation control (AGC) controllers in a more realistic 2-area interconnected power system with multi sources power plants in each area. The standard search technique; genetic algorithms (GAs) is adapted to search the optimal parameters of centralized and decentralized AGC controllers by developing integral square error (ISE) performance index as an objective function. However, the systems dynamic responses are obtained to compare performance of these AGC controllers for 1% step load disturbance at respective control areas in power systems. It has been investigated that when centralized AGC scheme is implemented for mitigating load disturbance in power system, the disturbed area is responsible to generate the extra power to cope with local load disturbance. Besides, it has also been observed that when decentralized AGC scheme was implemented in power systems, both the areas are responsible to remove load disturbance by contributing generation, which is equal to load disturbance. Keywords: AGC, GAs, Hydro power plant, Thermal power plant, Gas power plant, Electrical power system

Zinc (Zn) deficiency causes low crop production and malnutrition in human. Agronomic biofortification of food crops can resolve the issues of global food security and human nutrition on sustainable basis. Field experiments were conducted to improve Zn bioavailability, growth and yield of wheat in response to varying Zn application rates for two consecutive years (2016-17 & 2017-18). Significant increase in grain yield was recorded with the application of Zn. Highest grain yield (5.41 t ha-1) was recorded with the application of 5.00 kg Zn ha-1. Human available Zn fraction was also improved in response to Zn application. Zn application resulted in lowering phytate/Zn molar ration in wheat grains. Higher Zn accumulation (338.72 g ha-1) was observed by applying 7.5 kg Zn ha-1. Zinc application was found critical to meet internal (36.53 µg g-1) and external (4.48 kg Zn ha-1) Zn requirements to achieve near maximum yield of wheat. The results reinforced the concept of Zn fertilization to achieve better productivity and quality.

Logistics supply when emergency of disaster comes up that have some problems to be considered much as setting up of emergency operations center irregularly, less coordination between sectors, the data of victims is not properly recorded, and the logistics supply not appropriate with the need of victims. These problems occured because there are no information connected between sectors related to victim data, and the aid that has been fulfilled is very urgent logistics at the disaster site. Information system for distribution and logistics supplies during disaster response is needed to realize effective and efficient distribution. This information system design includes planning, system analysis, collecting data, system design, system testing and implementation. This research was conducted at BPPD office in Pidie Jaya Regency. This information distribution and logistics inventory system that is designed will simplify and accelerate the process of recording in distribution and logistics supply. The results of this system can be introduced to society, so that when disaster occurs the community will receive information quickly and accurately related to distribution and logistics supply

Summary: Background: WHO's haemoglobin cutoffs to define anemia were based on five studies of predominantly White adult populations, done over 50 years ago. Therefore, a general re-examination of the existing haemoglobin cutoffs is warranted for global application, in representative healthy populations of children and adults. Such data are scarce in low-income and middle-income countries; however, a 2019, large-scale, nationally representative survey of children and adolescents aged 0–19 years in India (Comprehensive National Nutrition Survey [CNNS]) offered an opportunity for this re-examination. Using this survey, we aimed to assess the age-specific and sex-specific percentiles of haemoglobin and cutoffs to define anaemia in the CNNS population. Methods: For this population-based study, we constructed age-specific and sex-specific haemoglobin percentiles from values reported for a defined healthy population in the CNNS, which used rigorous quality control measures during sample collection and in the laboratory analyses. To obtain a healthy population, we excluded participants with iron, folate, vitamin B12, and retinol deficiencies; inflammation; variant haemoglobins (haemoglobin A2 and haemoglobin S); and history of smoking. We considered age-specific and sex-specific 5th percentiles of haemoglobin derived for this healthy population as the study cutoff to define anaemia. We compared these with existing WHO cutoffs to assess significant differences between them at each year of age and sex for quantifying the prevalence of anaemia in the entire CNNS sample. Findings: Between Feb 24, 2016, and Oct 26, 2018, the CNNS survey collected blood samples from 49 486 individuals. 41 210 participants had a haemoglobin value, 8087 of whom were included in our study and comprised the primary analytical sample. Compared with existing WHO cutoffs, the study cutoffs for haemoglobin were lower at all ages, usually by 1–2 g/dL, but more so in children of both sexes aged 1–2 years and in girls aged 10 years or older. Aanemia prevalence with the study cutoffs was 19·2 percentage points lower than with WHO cutoffs in the entire CNNS sample with valid haemoglobin values across all ages and sexes (10·8% with study cutoffs vs 30·0% with WHO cutoffs). Interpretation: These findings support the re-examination of WHO haemoglobin cutoffs to define anaemia. Our haemoglobin reference percentiles, derived from healthy participants in a large representative Indian survey, are suitable for national use in India. Substantial variations in the 5th percentile of haemoglobin values across the 1–19 years age range and between sexes argue against constructing common cutoffs in stratified age groups for convenience. Funding: None. Translations: For the Hindi, Punjabi, Tamil and Kannada translations of the abstract see Supplementary Materials section.

Surface water supplies are gradually becoming short in arid and semi-arid regions of the world. Thus, assessment of groundwater quality for crop use appears to be very essential for management and utilization of precious natural water resources. This study reports the water quality of 52 hand pumps and one tubewell located in the most remote areas of desert region, viz. Islamkot and Mithi talukas of district Tharparkar. The water samples were collected during April 2016 (just before the start of rainy season). The water samples were analyzed for EC (Electrical Conductivity), pH, CO32-, HCO3-, Cl-, Ca2+, Mg2+ and Na+ concentration. The SAR (Sodium Adsorption Ratio) and RSC (Residual Sodium Carbonates) were estimated using their respective formula. The categorization of water samples based on their soluble salt content clearly revealed that the water bodies of majority (65%) of areas were hazardous, while 25% areas were marginal. Thus, only 11% water samples of the area under study had useable irrigation water. Because of SAR and RSC the majority (89 and 77%, respectively) of water samples were found to be free from the sodicity hazard. The study concluded that salinity, and not sodicity was the major threat to the area under irrigation with these water bodies. It is, therefore, suggested that the salinity tolerant crops and their genotypes may be used in this area to sustain crop production.

Most of the arable soils in Pakistan are deficient in plant available phosphorus (P) and boron (B) primarily due to alkaline and calcareous nature along with low organic matter. A combined deficiency of these nutrients may intensify the plant growth suppression by reducing their efficient utilization. A pot experiment was conducted to investigate the interactive effect of P and B on growth, nutrient accumulation and grain yield of wheat grown on calcareous soil. Wheat crop was grown at three P levels (45, 90 and 135 kg P ha-1) in combination with five B levels (0, 0.5, 1.0, 1.5 and 2.0 kg B ha-1) following completely randomized design. The results revealed that yield and yield related attributes increased linearly with the addition of B at each P level. Nonetheless, the significant interactive effect of both nutrients was most pronounced in the treatment having 90 kg P ha-1 and 1.5 kg B ha-1. Applied B rates resulted in relatively higher P concentration in grains and straw at P level of 90 kg ha-1 contrarily to 45 and 135 kg P ha-1. The B concentration in grains and straw increased with corresponding addition of B at each P level but at variable rate, with the maximum response at higher P level. Grain and straw yield illustrated positive correlation with total P uptake (R2 = 0.96 and 0.81) and total B uptake (R2 = 0.95 and 0.70) respectively. Likewise, positive correlation (R2 = 0.94) between total P uptake and total B uptake under combined application of P and B indicated their synergistic relationship. Overall, the treatment combination of 90 kg P ha-1 with 1.5 kg B ha-1 was found as the most suitable dose for better plant growth, nutrient accumulation and grain yield of wheat.

Objectives: Antioxidants can reduce oxidative radicals that affect the early phase of atherogenesis, that is endothelial dysfunction. Polysaccharide Peptide (PsP) derived from Ganoderma lucidum has an active substance in the form of β-glucan. Previous studies have proven the PsP of Ganoderma lucidum as an effective antioxidant in atherosclerotic rats and shows no toxicity in animal model. This study aims to prove the effect of PsP as potent antioxidant in high risk and stable angina patients. Method: This is a clinical trial conducted to 37 high risk and 34 stable angina patients, which were determined based on ESC Stable CAD Guidelines and Framingham risk score, with pre and post test design without control group. The parameters are superoxide dimustase (SOD) and malondialdehyde (MDA) concentration, circulating endothelial cell (CEC) and endothelial progenitor cell (EPC) counts. The patients were given PsP 750 mg/day in 3 divided dose for 90 days. Paired t-test was performed for normally distributed data, and Wilcoxon test for not normally distributed data, and significant level of p ≤ 0,05. Results: SOD level in high risk patients slightly increased but not statistically significant with p = 0,22. Level of SOD in stable angina group significantly increased with p = 0,001. MDA concentration significantly reduced in high risk and stable angina patients with p = 0.000. CEC significantly reduced both in high risk and stable angina patients, with p = 0.000 in both groups. EPC count significantly reduced in high risk and stable angina with p = 0.000. Conclusion: PsP of Ganoderma lucidum is a potent antioxidant against pathogenesis of atherosclerosis in stable angina and high risk patients Keywords: Polysaccharide peptide, Ganoderma lucidum, Antioxidant, Stable angina, High risk patients

What are the features of high-quality online courses in higher education? In this scoping review, we explore peer-reviewed scholarship related to the features of online learning in postsecondary contexts. We searched ERIC (EBSCO), Education Research Complete, and SocINDEX with Fulltext to retrieve peer-reviewed literature from 2010-2022 pertaining to features of online learning in higher education. Two reviewers independently conducted the initial title and abstract screening (n = 1,574), full text review (n = 483), and data extraction of the included articles (n = 38). Using thematic content analysis to explore the data extracted from each article, we found that the literature predominately included scholarship related to quality online course design, instructor facilitation in online courses, quality assessment of online courses, and student engagement in online courses. The breadth of these themes included a multiplicity of strategies and approaches to consider when designing online learning experiences. We recommend that administrators, faculty members, and instructors responsible for designing online courses and programs for postsecondary contexts continue to incorporate these considerations to promote high-quality and consistent online offerings. We conclude the review by presenting four high-level considerations to guide these discussions.

Purpose: It is evident employee react negatively and have experienced psychosomatic effects like depression, anxiety, insecurity and fear as a reaction of merger and acquisition, which reflect negative effect on employee performance, high turnover intention or absenteeism as employee reaction to change. The present study intent to understand the impact valuable perceived social support in enhancing employee job satisfaction and to persuade them not to switch the organization specifically due to structural change i.e. M&A. Design / methodology: The study is cross sectional, data collected convenience non-random sampling technique from MCB Bank employee experiencing structural change (MCB-NIB) merger. Total of 350 responses using Smart PLS were analyzed. Findings: It was found that perceived social support positively associated to job satisfaction. Job satisfaction negatively related to turnover intention and mediated the link between perceived social support and turnover intention. Research limitations: This study finding carries certain limitations like the data acquired gathered from one region which may indicate unfairness. It is cross sectional study so causal links cannot be established future research particular to longitudinal studies. This study only involved employees of banking sector from one province of Pakistan, still issue of generalizability cannot be ruled out. Practical implications: The study possess a number of practical implications as an outcome of present study stresses that executive need to provide in order to implement change. As Merger practice modifies the current organizational culture, working environments, and operations, employee feel negative and show fear of downsizing or restructuring. Thus managers and policy makers need to establish mechanism where employee may get enough support. Originality / value: The present study is distinctive in a way it has covered that employee developing their confidence, morale, acceptance and perception level, regarding change experience such as satisfaction with the job as an important mediating mechanism, which deal and overcome emotional response of an individual who intent from company at the time of change.

Synergy is coordination and cooperation between groups of people in order to achieve an efficient goal. An example of a synergy is the synergy between government agencies to improve access to clean water in relation to disaster management. This study aims to describe the synergy between Indonesia’s government agencies to improve access to clean water in relation to disaster management, determine the factors that affect the synergy, and recommend a synergy model. The study was conducted through a qualitative approach. Data were collected through in-depth interview with the heads of government agencies that had a duty to improve access to clean water, observation, and literature review. The data analysis technique was triangulation technique. The results of this study was that the synergy between the government agencies had not run well due to several inhibiting factors that were inefficient planning, overlapping work division, and no evaluation.

Abstract This article presents an application of bacterial foraging algorithm (BFA) for design and implementation of generation‐based PID structured automatic generation control (AGC) in a 2‐area multisources power system with hydro, thermal, and gas power plants incorporated in each area. Most of AGC studies carried out so far have considered the initial system loading to be equal to 50% of the area generation capacity. But, AGC controller parameters are uncertain due to stochastic nature of power demand of the end users. Hence, in this article, the design of AGC controller is proposed on the basis of generation schedule by incorporating changes in power system gain constant, power system time constant, frequency bias constant, and so on. The dynamic responses of power system with BFA tuned AGC controller are compared with the genetic algorithm tuned AGC controller. The parameters of the controllers are evaluated by using these techniques and investigations are carried out to find the best performance of the system. Therefore, it is desirable to find the parameters of the generation‐based controller depending upon the contribution of its constituent hydro, thermal, and gas energy sources in the total power generation.

Herein, a visual simultaneous localization and mapping (SLAM) is proposed in which both points and lines are extracted as features and a deep neural network is adopted for loop detection. Its working principles, including the representation, extraction, description, and matching of lines, initialization, keyframe selection, optimization of tracking and mapping, and loop detection using a deep neural network, are set forth in detail. The overall trajectory estimation and loop detection performance is investigated using the TUM RGB‐D (indoor) benchmark and KITTI (outdoor) datasets. Compared with the conventional SLAMs, the experimental results of this study indicate that the proposed SLAM is able to improve the accuracy and robustness of trajectory estimation, especially for the scenes with insufficient points. As for loop detection, the deep neural network turns out to be superior to the traditional bag‐of‐words model, because it decreases the accumulated errors of both the estimated trajectory and reconstructed scenes.

The objective of this study is to investigate anthropometric factors and physical fitness as determinants of futsal dribbling and passing skills of students aged 12-15 years. The population of this study was all extracurricular futsal players in Surakarta with a sample of 50 students obtained by simple random sampling technique. Data collection techniques used were tests and measurements. The data were analyzed with testing factor confirmatory analysis with the help of SPPS and Amos 21 program. The results of hypothesis testing proved that the overall anthropometric factors and physical fitness had a relationship to the skills of futsal dribbling and passing. The factors include: (1) Foot length with a regression coefficient value of 0.689, (2) Coordination with a regression coefficient value of 0.453, (3) Speed with a regression coefficient value of 0.237, (4) Endurance with a regression coefficient value of 0.229, (5) Flexibility with a regression coefficient value of 0.220, (6) Balance with a regression coefficient value of 0.237, and (7) Limb length with a regression coefficient value of -726. It can be concluded that the dominant factor to determine futsal dribbling and passing skills for 12-15 years old students is foot length.