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The shutting down of educational institutions not only in India, but all over the world has forced them to adapt to a new normal of online teaching through digital platforms. The sudden transition has caused a chaos in the education sector in India. Many studies have been conducted on the issues faced by the students in online classes but not teachers. The higher secondary school teachers are a group who has to adapt immediately to the digital classrooms and resources since their students are at a stage of their prospective career choosing. The present study analyses the issues of teachers during online teaching who are suddenly pushed in to the digital environment. The case study method was adopted for the study with the support of a structured interview schedule. The sample of the study consisted of 50 higher secondary teachers in different disciplines and different schools across Kerala, India. Due to the pandemic restrictions the sample size has to be kept a minimum number. The study mainly focused on the problems faced by the higher secondary teachers during the online teaching. The findings of the study showed that the online teaching is a pressure for them rather than a pleasure experience. Major issues faced by the teachers are the lack of computer competency, technical issues such as lack of internet connectivity, students' access to the digital devices and the occupational stress due to the disruption of work- life balance. Based on the findings, practical and social implications are analyzed and discussed.

Abstract We conducted a pre‐post intervention study to determine knowledge, attitude, and practice toward dietary salt intake before, immediately, and 1‐month after nurse‐led one‐on‐one counseling. We purposively selected three public health facilities in Agra, India, and enrolled all eligible hypertensive patients aged 18–60 under treatment for ≥6 months. Of the 153 patients at the 1‐month follow‐up, counseling improved knowledge (4% vs. 42%, p

ABSTRACT Background Pancreatic cancer (PC) is one of the most aggressive types of cancer. Despite advances in molecular diagnostics, PC diagnosis relies on imaging technologies and morphological assessment of fine needle aspirates (FNAs). MicroRNA (miRNA) involvement in PC pathogenesis and potential diagnostics application have been suggested, albeit current supporting evidence is lacking. Here, we investigated the association of selected miRNAs with PC incidence and clinical characteristics. Methods Fold expression of miR‐216a‐3p, ‐217‐5p, ‐221‐3p, ‐222‐3p, and miR‐196a‐5p was assessed in 73 PC FNA cell‐block sections and 6 healthy pancreas tissues using Taqman advanced miRNA assays. Potential miRNA targets were ascertained using immunocytochemistry. Results miR‐196a‐5p was upregulated in PC compared to healthy pancreatic tissue (β = −0.05, 95% CI: −0.065 – (−0.035); p

Motivation is imperative because it affects our lives every day. Motivation is the innate drive for all of our activities. All of our behaviors, actions, hope, and beliefs are altered by our inner drive to flourish. Our motives for achievement can range from living needs to satisfying creative needs or realizing success in competitive endeavors. These basic physiological motivational drives alter our natural behavior in different environments. Motivation refers to the dynamics of our practice, which involves our needs, desires, and ambitions in life. It can be well-defined as the driving force trailing all the actions of an individual. The influence of an individual's needs and enjoy both have a substantial impact on the direction of their behavior. It is placed on your feelings and achievement-related goals. There are different forms of motivation, including external, intrinsic, physiological, and achievement motivation. There are also more adverse forms of motivation. Attainment motivation is based on reaching success and achieving all of our desire in life. It has been imagined in many diverse ways. It can be forwarded as the need for progress or the attainment of quality. Individuals will fill their needs through different means and are driven to succeed for varying reasons, both internal and external. Achievement motives include the need for success and the fear of failure. These are the more predominant reasons that direct our behavior towards positive and negative consequences. The goals of the study were to find the levels, to find the significant association of achievement motivation and achievement based on locality, type of management, type of family and monthly income and to see the correlation between Achievement Motivation and Achievement. Survey Method was used for the present study. 300 higher secondary students were accepted by casual sampling technique from the more senior secondary schools of Kanyakumari district. Percentage Analysis, Mean, Standard Deviation, Chi-square, and Correlation were the statistical techniques used. SPSS analyst zed data and the results arrived. Based on the findings, suggestive measures for improvement were provided.

BackgroundNoncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions.MethodsA state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI).ResultsDue to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension.ConclusionThe burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.

Abstract The purpose of this study is to conduct an experimental assessment of the impact of RCCI (reactivity regulated compression ignition) on the performance, emissions, and combustion of a CRDI engine. A fuel mix (20% biodiesel, 80% diesel, and a NaOH catalyst) is generated. The produced combination is evaluated for attributes using standards established by the American Society for Testing and Materials (ASTM). The engine research included three distinct kinds of injections: 10% Pen RCCI, 20% Pen RCCI, and 30% Pen RCCI. Increasing the injection pressure increases the brake thermal efficiency, often known as BTE. NOx emissions increased as a consequence of higher injection pressures and improved combustion. However, when the injection rate is increased, the Specific Fuel Consumption (SFC) falls. The CO2 and hydrocarbon emissions, as well as the smoke opacity values, increased as the charge increased. The resultant mixture may be utilized in a CI engine with pre-mixed ignition to improve overall engine performance as well as combustion characteristics.

Background: Menstruation has always been surrounded by different perceptions throughout the world. Women with disability (WwD) face greater challenges in managing their menstruation hygienically and with dignity. It is essential to know the perceptions of WwD and their practices as they can be more vulnerable to infections. Objective: To assess the perceptions regarding menstruation and practices during menstrual cycles among WwD in a rural area of Bengaluru urban district. Methodology: This mixed-method study was done among WwD in the reproductive age group residing in a rural area of Bengaluru. A sample of 100 WwD were recruited for the quantitative part of the study using convenient sampling. Trained research assistants administered the study questionnaire comprising demography, knowledge, attitude and practices (KAP) during menstrual cycles. The qualitative part comprised of focus-group-discussions and in-depth-interviews among WwD and their caretakers. Results: The mean age of the participants was 27(±10.5) years, 15% were illiterate, 35% had locomotor-disability, 10% had multiple-disabilities, 18% severe disability and 9% were dependant on others during menstruation. Among WwD, 73% had knowledge about menstruation before attaining menarche, 94% felt that menstruation was a physiological process, 76% used sanitary pad during menstruation. The knowledge score ranged 0-7 with a mean of 5.19(±1.69). The attitude score ranged 5-25 with the mean being 14.89(±7.08) and practice score ranged 0-5 with mean of 2.19 (±0.79). Broad qualitative themes identified were, awareness on menstrual hygiene, challenges faced due to disability, social support and cultural practices. Qualitative findings revealed that women with physical disability were hesitant to step out fearing staining of clothes. Women raised concerns about a lack of autonomy when caregivers changed their pads. Conclusion: The perception among WwD regarding menstruation was found to be satisfactory but practices were inadequate. The WwD have been educated about safe and hygienic practices.

Introduction: Stress among undergraduate students has become a significant concern in higher education due to its detrimental effects on their health and academic performance. By exploring the association between various sociodemographic variables and stress levels, valuable insights into the factors contributing to stress among undergraduate students can be provided. Objectives: To determine the prevalence of stress and its associated factors among medical students in a tertiary care hospital Methods: A cross-sectional study was conducted among 133 undergraduate students selected utilising convenience sampling. A pre-designed close-ended questionnaire, specifically tailored for this study, was employed to collect data related to stress experienced by undergraduate students. Appropriate statistical analyses were performed with significance level set at p < 0.05. Results: The study revealed that 19% of the undergraduate students experienced high perceived stress, 67% experienced moderate stress and 13% experienced low stress levels. A significant association was observed between perceived stress and reduced appetite (p=0.014). Additionally, significant associations were found between stress and poor relationships with faculties (p=0.003); the warden (p=0.01); family members (p=0.003); facing time pressure(p=0.006); heavy workload (p=0.029); fear of failure (p=0.002); suffering from frequent exams (p=0.003); and exam patterns and curriculum (p=0.024). Conclusions & Recommendations: Results highlight considerable prevalence of stress among undergraduate students, with the majority demonstrating moderate stress levels. It is imperative to prioritise undergraduate students' mental and physical wellbeing by incorporating counselling services and preventive mental health programs as integral components of routine clinical services, so that educational institutions can foster a supportive learning environment.

To maintain ideal working conditions by removing heat, a particular technique must be applied. This research examines how nanofluids affect computer cooling microchannel heating devices. The experiment's working fluids are 25% Therminol-55 and 75% sprinkling water. The mixture contains silicon carbide (SiC), titanium oxide (TiO2), and zinc oxide (ZnO) nanoparticles. It includes 0.25% to 1.5% nanoparticles and flows at 0.025 to 0.080 kg/s at 25°C to 40°C. Central processing unit temperature, heat transfer rate, pressure losses, and pumping power have been examined. SiC-THERMINOL/SPRINKLING WATER at 1.5% concentration and 0.080 kg/s had a 9% lower temperature and 31% larger heat transfer coefficient than the base fluid. SiC-TL/SW has the highest pressure decrease and pumping force power compared to TiO2-TL/SW. Because nanofluid beats basic fluid in computer cooling, a little increase in pumping force power and pressure reduction may be tolerated. [ABSTRACT FROM AUTHOR]

A nanofluid is a solution of nanoparticles with diameters fewer than 100 nanometers suspended in a base fluid such as water, ethylene glycol, or oil. In the nanofluid, these nanoparticles are suspended. The goal of this research is to look at the functioning of a twin-pipe heat exchanger that uses counter flow arrangements and two different nanofluids as cooling fluids. Alkaline water is a basic fluid made up of silicon carbide (SiC) and carbon nanotubes (CNT). The goal of this research was to see how different compositions of SiC and CNT nanoparticles dispersed in water affected the heat transfer capacities of a twin pipe heat exchanger developed with a counterflow arrangement. The flow rate of the nanofluid and the particle volume concentration of alkaline water were (0.02) and (0.04), respectively. Fluids with constant intake temperatures of 60°C for water and 30°C for nanofluid flow at the same input velocity via a heat exchanger. Both fluids are traveling at the same rate. According to the findings, nanofluid absorbs more heat than water at a range of flow speeds. Because of the improved thermal properties of nanoscale fluids, this results in increased thermal efficiency in heat exchangers. [ABSTRACT FROM AUTHOR]

Background: Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19. Methods: An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed. Results: The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8–64.5), p = 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3–79.2), p < 0.001, and Covaxin was 73.4% (95% CI: 44.3–87.3). VE was highest, at 60.7% (95% CI: 23.6–81.3), when the two doses of the vaccine were given at an interval of less than 6 weeks. Participants with a baseline CD4 count > 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6–75.3) p = 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10). Conclusions: Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.

Prostatic malakoplakia is a rare chronic inflammatory disease with only a few cases reported in the literature. It is believed to be caused by an impaired histiocytic response against bacteria. This is a case report of a 65-year-old man with a history of diabetes mellitus presenting with complaints of generalized weakness and fever of 4-day duration. Laboratory investigations showed pyuria, and urine culture showed Escherichia coli. An abdominal Computerised Tomography (CT) scan revealed left-sided pyelonephritis and a prostatic abscess. Double-J stenting with Trans-Rectal Ultrasound Scan (TRUS) biopsy was done. The biopsy showed features of malakoplakia of the prostate without any associated malignancy.

Controlling airborne transmitted disease remains a challenge to clinicians, healthcare administrators, and engineers. Engineering measures are critical to any infection control program but can require extensive installation procedures, may be expensive to maintain, and may not always demonstrate clinical or financial benefit. We determined the financial and carbon benefits of an engineering solution to combat air pollutants and to control airborne transmitted disease. We determined the costs of healthcare associated infections (HAIs), and the costs of installation, maintenance, energy demands, and carbon impacts of an ACTIVE Particle ControlTM (APC) air-purification system. In a 20 month study with over 65,000 patient days the significant reductions in HAIs resulted in significant financial, energy, maintenance, and carbon savings from this engineering solution. Positive clinical and financial outcomes are possible with novel air-purification solutions such as APC.

Pseudomonas aeruginosa causes chronic infections, such as cystic fibrosis, endocarditis, bacteremia, and sepsis, which are life-threatening and difficult to treat. The lack of antibiotic response in P. aeruginosa is due to adaptive resistance mechanism, which prevents the entry of antibiotics into the cytosol of the cell to achieve tolerance. Among the different groups of antibiotics, aminoglycosides are used as a parenteral antibiotic for the treatment of P. aeruginosa. This study aimed to determine the kinetics of antibiotic tolerance and gene expression changes in P. aeruginosa exposed to amikacin, gentamicin, and tobramycin. These antibiotics were exposed to P. aeruginosa at their MICs and the experimental setup was monitored for 72 h, followed by the measurement of optical density every 12 h. The growth of P. aeruginosa in the MICs of antibiotics represented the kinetics of antibiotic tolerance in amikacin, gentamicin, and tobramycin. The transcriptomic profile of antibiotic exposed P. aeruginosa PA14 was taken from the Gene Expression Omnibus (GEO), NCBI as microarray datasets. The gene expressions of two datasets were compared by test versus control. Tobramycin-exposed P. aeruginosa failed to develop tolerance in MICs of 0.5 µg/mL, 1 µg/mL, and 1.5 µg/mL, whereas amikacin- and gentamicin-treated P. aeruginosa developed tolerance. This illustrated the superior in vitro response of tobramycin over gentamicin and amikacin. Further, in silico transcriptomic analysis of tobramycin-treated P. aeruginosa resulted in differentially expressed genes (DEGs), enriched in 16s rRNA methyltransferase E, B, and L, alginate biosynthesis genes, and several proteins of the type II secretion system (T2SS) and type III secretion system (T3SS). The regulation of mucA in alginate biosynthesis, and gidB in RNA methyltransferases, suggested an increased antibiotic response and a low probability of developing resistance during tobramycin treatment. The use of tobramycin as a parenteral antibiotic with its synergistic combination might combat P. aeruginosa with increased response.

Humans use context and scene knowledge to easily localize moving objects inconditions of complex illumination changes, scene clutter and occlusions. Inthis paper, we present a method to leverage human knowledge in the form ofannotated video libraries in a novel search and retrieval based setting totrack objects in unseen video sequences. For every video sequence, a documentthat represents motion information is generated. Documents of the unseen videoare queried against the library at multiple scales to find videos with similarmotion characteristics. This provides us with coarse localization of objects inthe unseen video. We further adapt these retrieved object locations to the newvideo using an efficient warping scheme. The proposed method is validated onin-the-wild video surveillance datasets where we outperform state-of-the-artappearance-based trackers. We also introduce a new challenging dataset withcomplex object appearance changes.

When modeling geo-spatial data, it is critical to capture spatialcorrelations for achieving high accuracy. Spatial Auto-Regression (SAR) is acommon tool used to model such data, where the spatial contiguity matrix (W)encodes the spatial correlations. However, the efficacy of SAR is limited bytwo factors. First, it depends on the choice of contiguity matrix, which istypically not learnt from data, but instead, is assumed to be known apriori.Second, it assumes that the observations can be explained by linear models. Inthis paper, we propose a Convolutional Neural Network (CNN) framework to modelgeo-spatial data (specifi- cally housing prices), to learn the spatialcorrelations automatically. We show that neighborhood information embedded insatellite imagery can be leveraged to achieve the desired spatial smoothing. Anadditional upside of our framework is the relaxation of linear assumption onthe data. Specific challenges we tackle while implementing our frameworkinclude, (i) how much of the neighborhood is relevant while estimating housingprices? (ii) what is the right approach to capture multiple resolutions ofsatellite imagery? and (iii) what other data-sources can help improve theestimation of spatial correlations? We demonstrate a marked improvement of 57%on top of the SAR baseline through the use of features from deep neuralnetworks for the cities of London, Birmingham and Liverpool.

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.

Objective: To study the transmission dynamics of coronavirus disease 2019 (COVID-19) among 101 confirmed cases and their 387 household contacts and to determine risk factors associated with secondary attack among the household contacts. Methods: A prospective cohort study was conducted from January 1st 2021 to February 28th 2021, among 101 SARS-CoV-2 cases and 387 household contacts who were followed up for 14 days from the last day of contact with the index case of COVID-19. The dynamics of disease transmission was estimated, and factors affecting transmission risk were analyzed. Besides, the association between various factors and household secondary attack rate was determined. Results: The median incubation period was found to be 5 days, and the observed reproductive number (R) was found to be 1.63 (95% CI: 1.28-1.98). The mean household secondary attack rate was 40.7%. Contacts with comorbidities like diabetes mellitus, hypertension, dyslipidemia, and hypothyroidism had significantly higher attack rates (P

Background: Infiltration of tumors by dendritic reticulum cells (DRC) reflects the host immune defense mechanism. We observed three breast carcinomas cases with dense tumor-infiltrating DRC and lymphocytes in fine-needle aspiration (FNA) smears, leading to cytodiagnosis or differential diagnosis of dendritic reticulum cell sarcoma (DRCS). An attempt was made to find out the reason behind such an erroneous interpretation. Materials and Methods: Between 2009 and 2014, two cases were diagnosed as DRCS of the female breast by FNA cytology and in one case possibility of DRCS was considered along with medullary breast carcinoma (MBC). We compare and contrast the cytomorphological features of these three cases with those of nine cytologically diagnosed MBC. Results: Cases diagnosed as DRCS or MBC showed singly dispersed tumor cells, nuclear pleomorphism, bare nuclei, prominent nucleoli, and presence of lymphocytes. There was no significant difference between the two groups for discohesive clusters, syncytial clusters, plasma cells, neutrophils, foamy histiocytes, and necrosis. However, there was significant difference for presence of cohesive clusters (0% DRCS and 100% MBC,P = 0.00485), severe degree (+++) of pleomorphism (100% DRCS vs. 11.1% MBC,P = 0.01818), +++ DRC (P = 0.04697), and DRC with ++ to +++ enlarged nuclei (P = 0.03333), and pleomorphic nuclei (P = 0.00833). Two of the three cytologically diagnosed DRCS cases proved to be MBC or MBC-like and one as invasive ductal carcinoma. Six of nine cytologically diagnosed MBC cases with histology proved to be invasive breast carcinomas. Conclusion: Criteria for cytodiagnosis MBC need a fresh look. Cases with numerous dendritic cells possibly represent MBC.

Education should be made painless and the teaching must be made effective. Teaching is an activity, which is designed and performed for multiple objectives, in terms of changes in student behaviours. Models of teaching are just a blue print designed in advance for providing necessary structure and direction to the teacher for realizing the stipulated objectives. Ausubel in his theory of meaningful verbal learning, presents the most important ideas, phenomena and other difficult words in the beginning of instruction, so that the learner can easily understand each and every concept and learning becomes meaningful. According to Ausubel's Advance Organizer Model of Teaching (AOMT), the concepts are hierarchically organized from simple to very abstract and all the concepts are linked together. Ausubel believes that structural concepts of each discipline can be identified and taught to the students and the students can become an information processing system to solve problems. The objective of the study is to find out the effect of AOMT on the achievement, gain and retention of the secondary prospective teachers in physical science. The investigator adopted Pre-test-Post-test Equivalent Group Design for the study. Sixty prospective teachers, 30 for experimental group and 30 for control group, were selected as sample. Statistical techniques used were standard deviation and t- test for independent variables. Findings of the study reveal that performance and retaining capacity of the experimental group are significantly higher than that of the control group.

We analyzed the tree-rings δ18O of Abies spectabilis (fir) growing at the subalpine treeline ecotone in the Magguchatti valley. The valley is located in the Indian summer monsoon (ISM) dominated region of western Himalaya and also receives snow precipitation derived by westerly disturbances (WDs) during the winter months. The 60 year developed (1960–2019 CE) tree-ring δ18O chronology revealed a strong positive correlation with the temperature of late winter and spring months (February to April). Strong negative correlations are also apparent for snowcover, soilmoisture, and relative humidity for the same spring season. Our findings partly contrast the significant correlation results of tree-ring δ18O with summer precipitation and drought indices recorded from other summer monsoon-dominated regions in the Himalayas. The spatial correlation analyses with sea surface temperatures (SSTs) and climate parameters showed subdued signals of tropical Pacific at the site, but with a shift to more moisture influx from the Arabian Sea during the last two decades. Moreover, a significant negative correlation with North Atlantic Oscillation further justifies the strongly captured spring temperature and snowcover signals and the weak effect of summer precipitation in fir trees. A temperature rising trend during the latter half of the 20th century and the elevation effect are taken as important factors controlling the moisture source at the treeline ecotone zones.

BackgroundB-cell lymphoma/leukaemia 11A (BCL11A) is a C2H2-type zinc-finger transcription factor protein that is a critical modulator of haemoglobin switching and suppresses the production of foetal haemoglobin. Variation in the BCL11A gene ameliorates the severity of sickle cell disease (SCD) and β-thalassemia (β-thal). The BCL11A gene is located on chromosome 2p16.1 and encodes an 835-amino acid protein.MethodUsing state-of-the-art in silico tools, this study examined the most pathogenic non-synonymous single nucleotide polymorphisms (nsSNPs) that disrupt the BCL11A protein and mediate foetal-to-adult globin switching. A total of 11,463 SNPs were retrieved from the Single Nucleotide Polymorphism database (dbSNP). These included 799 in the 5' untranslated region (UTR), 486 in the 3' UTR, and 266 non-synonymous, 189 coding synonymous, six nonsense, and six stop-gained SNPs.Results and discussionIn silico tools (SIFT, SNAP, PolyPhen-2, PANTHER, I-Mutant, PROVEAN, SNPs&GO, mCSM, and PhD-SNP) predicted the five most-deleterious nsSNPs: rs61742690, rs62142605, rs17028351, rs115666026, and rs74987258. Molecular dynamic simulation and homology modelling of the mutated proteins (S783N, D643N, G451S, K670R, and M313L) of the most deleterious nsSNPs revealed their functional and structural impact. nsSNP rs61742690 was predicted to be the most deleterious, as supported by eight of the nine in silico tools.ConclusionsComplete failure in the protein-protein interactions with functional partners (KLF1 and others) and significant changes (±100% variation) in the interface energy revealed that rs61742690 (S783N) in the zinc-finger domain is a suitable target for disrupting BCL11A-mediated foetal-to-adult globin switching.

INTRODUCTION:There is lack of information on the proportion of new smear-positive pulmonary tuberculosis (PTB) patients treated with a 6-month thrice-weekly regimen under Revised National Tuberculosis Control Programme (RNTCP) who develop recurrent TB after successful treatment outcome. OBJECTIVE:To estimate TB recurrence among newly diagnosed PTB patients who have successfully completed treatment and to document endogenous reactivation or re-infection. Risk factors for unfavourable outcomes to treatment and TB recurrence were determined. METHODOLOGY:Adult (aged ≥ 18 yrs) new smear positive PTB patients initiated on treatment under RNTCP were enrolled from sites in Tamil Nadu, Karnataka, Delhi, Maharashtra, Madhya Pradesh and Kerala. Those declared "treatment success" at the end of treatment were followed up with 2 sputum examinations each at 3, 6 and 12 months after treatment completion. MIRU-VNTR genotyping was done to identify endogenous re-activation or exogenous re-infection at TB recurrence. TB recurrence was expressed as rate per 100 person-years (with 95% confidence interval [95%CI]). Regression models were used to identify the risk factors for unfavourable response to treatment and TB recurrence. RESULTS:Of the1577 new smear positive PTB patients enrolled, 1565 were analysed. The overall cure rate was 77% (1207/1565) and treatment success was 77% (1210 /1565). The cure rate varied from 65% to 86%. There were 158 of 1210 patients who had TB recurrence after treatment success. The pooled TB recurrence estimate was 10.9% [95%CI: 0.2-21.6] and TB recurrence rate per 100 person-years was 12.7 [95% CI: 0.4-25]. TB recurrence per 100 person-years varied from 5.4 to 30.5. Endogenous reactivation was observed in 56 (93%) of 60 patients for whom genotyping was done. Male gender was associated with TB recurrence. CONCLUSION:A substantial proportion of new smear positive PTB patients successfully treated with 6 -month thrice-weekly regimen have TB recurrence under program settings.