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In the past two decades, rapid urbanization and globalization have adversely changed our lifestyle and diet habits. Our traditional healthy food habits have been replaced by processed foods with low nutritive value. These measures also saw a high prevalence of depression and other psychiatric disorders not only in western, urbanized countries but also in other developing countries as well. Long-term undernutrition due to deficiency of micronutrients such as iodine and iron can lead to increased chances of physical and mental disabilities. Undernourished children have less energy, decreased curiosity, and less interest in physical activities as well as they lack communication skills. These factors impair their physical, mental, and cognition. The aim of this article was to find the association of micronutrients especially minerals in patients with major depressive disorders. An adequate supply of nutrients is essential to regulate microbiome health and to improve the efficacy of other psychotherapeutic and psychopharmacological interventions. Lifestyle interventions in the form of dietary coaching could be used as promising, cost-effective, and practical intervention in depressed individuals. Nutritional interventions should be integrated in the multifactorial and treatment-resistant psychiatry patients. [ABSTRACT FROM AUTHOR]

Presents a study investigating the impact of material-parameter uncertainty on the steady-state performance of passivated 4H-SiC thyristors. Methodology used to conduct the study; Information on the surface recombination velocity for electrons and holes; Findings of the study.

Two-dimensional simulations were performed to optimize the waveguiding region's aluminum composition of an AlGaN/GaN separate confinement heterostructure (SCH) laser with large band discontinuities. Results demonstrate that the active region's thickness, waveguiding regions' thickness, and the material composition of the waveguiding region should be optimized, based on losses of the materials in the structure. Results also demonstrate that the threshold current of a SCH laser may be larger than that of a double heterostructure laser. The increase is caused by a competition between the active region and the waveguiding region which has a parasitic effect on the laser's modal gain because of the waveguiding region's slightly larger band gap, so that below the lasing threshold, photon emission and population inversion can occur in both regions. At the minimum threshold current the structure is optimized to strongly confine both the guided optical mode and the charge carriers responsible for the gain. [ABSTRACT FROM AUTHOR]

Presents information on a study that performed a numerical simulation of AlGaN/InGaN double-heterostructure light-emitting diodes. Simulation procedure; Results and discussion; Conclusion.

Study Objective Adolescent girls face a gamut of problems of which the menstrual problems are the most common. Because menstrual problems are subtle, the problems often are unreported. The objective of this study was to estimate the prevalence of menstrual problems, namely dysmenorrhea, menorrhagia, and irregular menstrual cycles. Design Cross sectional study. Setting School-based study conducted in a rural school of the Thiruvallur district, Tamil Nadu. Participants The participants were adolescent girls who attained menarche at least 1 year before the data collection period were selected using a simple random sampling method. A total of 350 participants were included in the study. Interventions No interventions were done. A structured, pretested questionnaire was used to collect data. Main Outcome Measures The main outcome measured in this study was the prevalence of menstrual problems, namely dysmenorrhea, menorrhagia, and irregular menstrual cycles. Results The mean age of the study participants was 14.74 years. The mean age at menarche was 12.4 years. In this study, 87.7% of the girls suffered from a menstrual problem. Overall, dysmenorrhea was prevalent in 72.6%, and menorrhagia and irregular menstrual cycles were present among 45.7% and 31.7% of the participants, respectively. Conclusion Menstrual problems form an important domain of adolescent health and because these problems go unreported, it is necessary that adequate attention and care is provided. The consequences of the neglect of menstrual problems results in impaired reproductive and sexual health in older women. [ABSTRACT FROM AUTHOR]

Background: Anemia during adolescence affects growth and development of girls and boys increasing their vulnerability to dropping out-of-school. Hence investing in preventing anemia during adolescence is critical for their survival, growth and development. Objective: To find out the burden of anemia on adolescent age group in the tribal area of Jhagadia block and to assess the change in the hemoglobin level through the weekly Iron and Folic Acid IFA (DOTS) directly observed treatment supplementation under Supervision by Peer Educators at Community level among adolescents. Methods: Community based intervention study conducted with adolescents (117 girls and 127 boys) aged 10-19 years, through supplementation of IFA (DOTS) by trained Peer Educators for 52 weeks in 5 tribal villages of Jhagadia. Hemoglobin level was determined by HemoCue method before and after intervention and sickle cell anemia by Electrophoresis method. Primary data on hemoglobin and number of tablets consumed was collected and statistically analyzed in SPSS 16.0 software by applying paired t-test. Results: The overall findings suggest that the prevalence of anemia reduced from 79.5% to 58% among adolescent girls and from 64% to 39% among boys. Mean rise of hemoglobin seen was 1.5 g/dl among adolescent boys and 1.3 g/dl among girls. A significant association was found in change in hemoglobin before and after intervention (P = 0.000) Conclusion: Prevalence of anemia among girls and boys can be reduced in their adolescent phase of life, through weekly supplementation of iron folic acid tablets under direct supervision and Nutrition Education by Peer Educator at community level. [ABSTRACT FROM AUTHOR]

Objective To understand changes in epidemiology of maternal mortality in rural India in the context of increasing institutional deliveries and implementation of community-based interventions that can inform policies to reach MDG-5. Methods This study is a secondary analysis of prospectively collected community-based data of every pregnancy and its outcomes from 2002 to 2011 in a rural, tribal area of Gujarat, India as part of safe-motherhood programme implemented by voluntary organisation, SEWA Rural. The programme consisted of community-based interventions supported by a first referral unit, and promotion of institutional deliveries. For every maternal death, a verbal autopsy was conducted. The incidence rates for maternal mortality according to place, cause and timing of maternal deaths in relation to pregnancy were computed. Annual incidence rate ratios ( IRR) and 95% confidence intervals, adjusted for caste and maternal education, were estimated using Poisson regression to test for linear trend in reduction in mortality during the study period. Results Thirty-two thousand eight hundred and ninety-three pregnancies, 29 817 live births and 80 maternal deaths were recorded. Maternal mortality ratio improved from 607 (19 deaths) in 2002-2003 to 161 (five deaths) in 2010-2011. The institutional delivery rate increased from 23% to 65%. The trend of falling maternal deaths was significant over time, with an annual reduction of 17% (adjusted IRR 0.83 CI 0.75-0.91, P-value <0.001). There were significant reductions in adjusted incidence rate of maternal deaths due to direct causes, during intrapartum and post-partum periods, and those which occurred at home. However, reductions in incidence of maternal deaths due to indirect causes, at hospital and during antepartum period were not statistically significant. Most maternal deaths are now occurring at hospitals and due to indirect causes. Conclusion Gains in institutional deliveries and community-based interventions resulting in fewer maternal deaths due to direct causes should be maintained. However, it would be essential to now prioritise management of indirect causes of maternal mortality during pregnancy at community and hospitals for further reduction in maternal deaths to achieve MDG-5. [ABSTRACT FROM AUTHOR]

The study was undertaken to determine diagnostic accuracy of Haemoglobin Colour Scale (HCS) in hands of village-based community health workers (CHWs) in real-life community setting in India. Participants (501 women) were randomly selected from 8 villages belonging to a project area of SEWA-Rural, a voluntary organization located in India. After receiving a brief training, CHWs and a research assistant obtained haemoglobin readings using HCS and HemoCue (reference) respectively. Sensitivity, specificity, positive and negative predictive-values, and likelihood ratios were calculated. Bland-Altman plot was constructed. Mean haemoglobin value, using HCS and HemoCue were 11.02 g/dL (CI 10.9-11.2) and 11.07 g/dL (CI 10.9-11.2) respectively. Mean difference between haemoglobin readings was 0.95 g/dL. Sensitivity of HCS was 0.74 (CI 0.65-0.81) and 0.84 (CI 0.8-0.87) whereas specificity was 0.84 (CI:0.51-0.98) and 0.99 (CI:0.97-0.99) using haemoglobin cutoff limits of 10 g/dL and 7 g/dL respectively. CHWs can accurately diagnose severe and moderately-severe anaemia by using HCS in real-life field condition after a brief training. [ABSTRACT FROM AUTHOR]

The study was undertaken to determine diagnostic accuracy of Haemoglobin Colour Scale (HCS) in hands of village-based community health workers (CHWs) in real-life community setting in India. Participants (501 women) were randomly selected from 8 villages belonging to a project area of SEWA-Rural, a voluntary organization located in India. After receiving a brief training, CHWs and a research assistant obtained haemoglobin readings using HCS and HemoCue™ (reference) respectively. Sensitivity, specificity, positive and negative predictive-values, and likelihood ratios were calculated. Bland-Altman plot was constructed. Mean haemoglobin value, using HCS and HemoCue™ were 11.02 g/dL (CI 10.9-11.2) and 11.07 g/dL (CI 10.9-11.2) respectively. Mean difference between haemoglobin readings was 0.95 g/dL. Sensitivity of HCS was 0.74 (CI 0.65-0.81) and 0.84 (CI 0.8-0.87) whereas specificity was 0.84 (CI:0.51-0.98) and 0.99 (CI:0.97- 0.99) using haemoglobin cutoff limits of 10 g/dL and 7 g/dL respectively. CHWs can accurately diagnose severe and moderately-severe anaemia by using HCS in real-life field condition after a brief training. [ABSTRACT FROM AUTHOR]

Background and Methods: We examined data from a cohort of births that occurred in the period 2004–08 in the SEWA-Rural project area, covering a population of ∼175000, in Gujarat, India, to assess the trends and risk factors for neonatal mortality.Results: In this population living in 168 villages, there has been a significant declining trend in infant and neonatal mortality, more marked in the tribal population, in whom this paralleled a rise in the proportion of women delivering in hospitals. The more important risk factors for neonatal mortality risk to emerge from multivariate analysis are low birth weight, prematurity, young age of mother, older mother and high birth order.Conclusion: Although community based interventions along with promotion of hospital birth has an impact in reducing neonatal deaths in this community, sustaining this momentum may demand more long-term policy interventions to promote better living standards and better reproductive health. [ABSTRACT FROM PUBLISHER]

Abstract: The contact resistance, ρ C, was measured for the traditional Ti/Al/Ni/Au Ohmic contact for samples implanted with Si to >1020 cm−3 and annealed at 1100, 1150, 1200, or 1250°C for 2, 5 or 10min using an AlN annealing cap. These results are compared with those for samples annealed in the same way, but were not implanted. The as-grown samples were doped to 3.56×1017 or 6.67×1016 cm−3 or were unintentionally (UI) doped. In almost all cases, ρ C for the implanted sample was lower, and a record low ρ C =2.66×10−8 Ωcm2 was achieved for the more heavily doped implanted sample annealed at 1200°C for 10min. ρ C decreased with the doping concentration, and for the UI samples, Ohmic contacts could be made only if the samples were implanted. The surface roughness was also measured, and it was found for an as-grown with an RMS roughness of 0.303nm, the roughness increased from 0.623 after an 1100°C anneal to 3.197nm after a 1250°C anneal for the implanted samples annealed for 10min, and it increased from 1.280nm to 5.357nm under the same conditions for the samples that were not implanted. [Copyright &y& Elsevier]

OBJECTIVE--To determine mechanisms by which pioglitazone and metformin effect hepatic and extra-hepatic insulin action. RESEARCH DESIGN AND METHODS--Thirty-one subjects with type 2 diabetes were randomly assigned to pioglitazone (45 mg) or metformin (2,000 rag) for 4 months. RESULTS--Glucose was clamped before and after therapy at ∼5 mmol/l, insulin raised to ∼180 pmol/l, C-peptide suppressed with somatostatin, glucagon replaced at ∼75 pg/ml, and glycerol maintained at ∼200 mmol/l to ensure comparable and equal portal concentrations on all occasions. Insulin-induced stimulation of glucose disappearance did not differ before and after treatment with either pioglitazone (23 ± 3 vs. 24 ± 2 µmol ⋅ kg-1 ⋅ min-1) or metformin (22 ± 2 vs. 24 ± 3 µmol ⋅ kg-1 ⋅ min-1). In contrast, pioglitazone enhanced (P < 0.01) insulin-induced suppression of both glucose production (6.0 ± 1.0 vs. 0.2 ± 1.6 µmol ⋅ kg-1 ⋅ min-1) and gluconeogenesis (n = 11; 4.5 ± 0.9 vs. 0.8 ± 1.2 µmol ⋅ kg-1 ⋅ min-1. Metformin did not alter either suppression of glucose production (5.8 ± 1.0 vs. 5.0 ± 0.8 µmol ⋅ kg-1 ⋅ min-1) or gluconeogenesis (n = 9; 3.7 ± 0.8 vs. 2.6 ± 0.7 µmol ⋅ kg-1 ⋅ min-1). Insulin-induced suppression of free fatty acids was greater (P < 0.05) after treatment with pioglitazone (0.14 ± 0.03 vs. 0.06 ± 0.01 mmol/l) but unchanged with metformin (0.12 ± 0.03 vs. 0.15 ± 0.07 mmol/l). CONCLUSIONS--Thus, relative to metformin, pioglitazone improves hepatic insulin action in people with type 2 diabetes, partly by enhancing insulin-induced suppression of gluconeogenesis. On the other hand, both drugs have comparable effects on insulin-induced stimulation of glucose uptake. Diabetes 57: 24-31, 2008 [ABSTRACT FROM AUTHOR]

The present study sought to determine whether elevated plasma free fatty acids (FFAs) alter the splanchnic and muscle glucose metabolism in women. To do so, FFAs were increased in seven women by an 8-h Intralipid/heparin (IL/hep) infusion, and the results were compared with those observed in nine women who were infused with glycerol alone. Glucose was clamped at ∼8.3 mmol/l and insulin was increased to ∼300 pmol/l to stimulate both muscle and hepatic glucose uptake. Insulin secretion was inhibited with somatostatin. Leg and splanchnic glucose metabolism were assessed using a combined catheter and tracer dilution approach. The glucose infusion rates required to maintain target plasma glucose concentrations were lower (P < 0.01) during IL/hep than glycerol infusion (30.8 ± 2.6 vs. 650 ± 7.9 µmol · kg[sup -1] · min[sup -1]). Whole body glucose disappearance (37.0 ± 2.2 vs. 70.9 ± 8.7 µmol · kg[sup -1] · min[sup -1]; P < 0.001) and leg glucose uptake (24.3 ± 4.2 vs. 59.6 ± 10.0 µmol · kg fat-free mass of the leg[sup -1] · min[sup -1]; P < 0.02) were also lower, whereas splanchnic glucose production (8.2 ± 0.8 vs. 4.3 ± 0.7 µmol · kg[sup -1] · min[sup -1]; P < 0.01) was higher during IL/hep than glycerol infusion. We conclude that in the presence of combined hyperinsulinemia and hyperglycemia, elevated FFAs impair glucose metabolism in women by inhibiting wholebody glucose disposal, muscle glucose uptake, and suppression of splanchnic glucose production. [ABSTRACT FROM AUTHOR]

Reports on two-dimensional electrothermal simulations to improve the reliability of high-power silicon carbide-gate turnoff thyristors. Occurrence of less device heating in a given number of cycles as indicated by transient mixed mode results; Observation of the hot spot to move from beneath the gate at the start of the turnoff to the corner formed by mesa isolation.

Presents a study which developed an operational technique, growth requirements and pn-pn-pn type structures to address the issues of high on-state voltage and other problems on breakover voltages in silicon carbide thyristors. Procedures for the fabrication of thyristors; Discussion; Results.

Presents a study that examined the effect of enteral delivery of glucose on splanchnic glucose metabolism. Assessment of concentrations of glucose, insulin and C-peptide; Measurement of the rates of intravenous and intraduodenal glucose infusion; Analysis of endogenous glucose production and glucose disappearance.

The present study sought to determine whether elevated plasma free fatty acids (FFAs) alter the ability of insulin and glucose to regulate splanchnic as well as muscle glucose metabolism. To do so, FFAs were increased in 10 subjects to approximately 1 mmol/l by an 8-h Intralipid/heparin (IL/Hep) infusion, whereas they fell to levels near the detection limit of the assay (<0.05 mmol/l) in 13 other subjects who were infused with glycerol alone at rates sufficient to either match (n = 5, low glycerol) or double (n = 8, high glycerol) the plasma glycerol concentrations observed during the IL/Hep infusion. Glucose was clamped at approximately 8.3 mmol/l, and insulin was increased to approximately 300 pmol/l to stimulate both muscle and hepatic glucose uptake. Insulin secretion was inhibited with somatostatin. Leg and splanchnic glucose metabolism were assessed using a combined catheter and tracer dilution approach. Leg glucose uptake (21.7 +/- 3.5 vs. 48.3 +/- 9.3 and 57.8 +/- 11.7 micromol x kg(-1) leg x min(-1)) was lower (P < 0.001) during IL/Hep than the low- or high-glycerol infusions, confirming that elevated FFAs caused insulin resistance in muscle. IL/Hep did not alter splanchnic glucose uptake or the contribution of the extracellular direct pathway to UDP-glucose flux. On the other hand, total UDP-glucose flux (13.2 +/- 1.7 and 12.5 +/- 1.0 vs. 8.1 +/- 0.5 micromol x kg(-1) x min(-1)) and flux via the indirect intracellular pathway (8.4 +/- 1.2 and 8.1 +/- 0.6 vs. 4.8 +/- 0.05 micromol x kg(-1) x min(-1)) were greater (P < 0.05) during both the IL/Hep and high-glycerol infusions than the low-glycerol infusion. In contrast, only IL/Hep increased (P < 0.05) splanchnic glucose production, indicating that elevated FFAs impaired the ability of the liver to autoregulate. Splanchnic insulin extraction, directly measured using the arterial and hepatic vein catheters, did not differ (67 +/- 3 vs. 71 +/- 5 vs. 69 +/- 1%) during IL/Hep and high- and low-glycerol infusions. We conclude that elevated FFAs exert multiple effects on glucose metabolism. They inhibit insulin- and glucose-induced stimulation of muscle glucose uptake and suppression of splanchnic glucose production. They increase the contribution of the indirect pathway to glycogen synthesis and impair hepatic autoregulation. On the other hand, they do not alter either splanchnic glucose uptake or splanchnic insulin extraction in nondiabetic humans. [ABSTRACT FROM AUTHOR]

Although it is well established that glucagon-like peptide 1(7-36) amide (GLP-1) is a potent stimulator of insulin secretion, its effects on insulin action and glucose effectiveness are less clear. To determine whether GLP-1 increases insulin action and glucose effectiveness, subjects with type 2 diabetes were studied on two occasions. Insulin was infused during the night on both occasions to ensure that baseline glucose concentrations were comparable. On the morning of study, either GLP-1 (1.2 pmol x kg(-1) x min(-1)) or saline were infused along with somatostatin and replacement amounts of glucagon. Glucose also was infused in a pattern mimicking that typically observed after a carbohydrate meal. Insulin concentrations were either kept constant at basal levels (n = 6) or varied so as to create a prandial insulin profile (n = 6). The increase in glucose concentration was virtually identical on the GLP-1 and saline study days during both the basal (1.21 +/- 0.15 vs. 1.32 +/- 0.19 mol/l per 6 h) and prandial (0.56 +/- 0.14 vs. 0.56 +/- 0.10 mol/l per 6 h) insulin infusions. During both the basal and prandial insulin infusions, glucose disappearance promptly increased after initiation of the glucose infusion to rates that did not differ on the GLP-1 and saline study days. Suppression of endogenous glucose production also was comparable on the GLP-1 and saline study days during both the basal (-2.7 +/- 0.3 vs. -3.1 +/- 0.2 micromol/kg) and prandial (-3.1 +/- 0.4 vs. -3.0 +/- 0.6 pmol/kg) insulin infusions. We conclude that when insulin and glucagon concentrations are matched, GLP-1 has negligible effects on either insulin action or glucose effectiveness in people with type 2 diabetes. These data strongly support the concept that GLP-1 improves glycemic control in people with type 2 diabetes by increasing insulin secretion, by inhibiting glucagon secretion, and by delaying gastric emptying rather than by altering extrapancreatic glucose metabolism. [ABSTRACT FROM AUTHOR]

Provides information on a study which compared Shubnikov-de Haas oscillation and Hall Measurement results with HEMT dc and rf characteristics for two different MOCVD grown HEMT structures. Procedures; Results and discussion; Conclusion.

Studies the impact of the lack of suppression of glucagon on glucose tolerance in humans. Plasma insulin, glucagon, C-peptide, and growth hormone concentrations; Endogenous glucose production; Rates of endogenous glucose production during either diabetic and nondiabetic insulin profiles.

Presents a study which determined whether lack of glucagon suppression causes hyperglycemia when insulin secretion is impaired. Methods; Results and discussion.

Presents calculations of the threshold current densities in AlGaN/GaN double heterostructure lasers for different active region thickness, losses and cavity lengths. Simulation procedure; Device structure; Mode confinement factors.

Presents a study which tested isomers and moieties of acetophenones for their effectiveness as bird repellents to better understand the nature of repellency in birds. Implication of identification of potential repellents through molecular modelling; Methods; Advantages of identification of an environmentally safe avian repellent.

Tests the effectiveness of five chemical bird repellents at reducing consumption of pond water containing cyanide using European starlings (Sturnus vulgaris) as an avian model. Total water consumption; Short-term pattern of consumption; Absolute repellency; Stability of repellents.

The authors response to comments on their research which examined the perioperative glucose control in diabetic patients undergoing elective surgery. Topics covered include their clarification of not advocating intensive glucose control during perioperative period, target blood glucose and avoidance of hypoglycemia and a meta-analysis showing that good glucose control is beneficial.

This Clinical Update proposes a management algorithm to prevent perioperative hyperglycemia in patients with diabetes undergoing elective surgery. [ABSTRACT FROM AUTHOR]

The article presents a case study conducted to examine the effectiveness of the maternity schemes in Gujarat to increase institutional deliveries. It mentions that the study is based on a secondary analysis of community based data collected by village level frontline workers of SEWA‑Rural (SR), a NGO located in Jhagadia block of Gujarat since 1980. It concludes that most of the women who delivered at hospital after initiation of maternity schemes chose hospital for subsequent delivery.

A 42-year-old end stage renal disease (ESRD) patient was admitted with fever, anorexia, malaise, non-productive cough, and dyspnea, of one-week duration. Multiple cultures of the blood, sputum, and urine were negative for microorganisms. The possibility of bronchiolitis obliterans with organizing pneumonia (BOOP) was considered when patient with pulmonary infiltrate did not respond to conventional antibiotic therapy and frequent hemodyalisis. High-resolution computed tomography of the chest revealed patchy air-space consolidation, ground-glass opacities, and small nodular opacities, predominantly located at the peripheral part of the lungs. Cultures and stains of bronchoalveolar lavage (BAL) specimen and bronchoscopic biopsy of lung tissue were negative for organisms [bacteria, mycobacterium tuberculosis, PCP, fungus, and atypical organism] and showed evidence of BOOP. Patient recovered completely with early diagnosis and treatment with steroids and underwent successful renal transplantation with wife as donor without postoperative complication and relapse. [ABSTRACT FROM AUTHOR]

Treatment of patients with amlodipine overdose remains challenging. We describe a case of successful treatment of refractory hypotension, noncardiogenic pulmonary edema and acute kidney injury after an intoxication with 250 mg of amlodipine. Marked improvement in all hemodynamic parameters was noted with combination of fluids, inotropes, low-dose calcium, low dose insulin, mechanical ventilation and hemodialysis. All available information on overdose of amlodipine is limited to case reports and series. Prospective trial on the use of these agents is required to define its role as the first-line treatment in amlodipine, a calcium channel blockers overdos. [ABSTRACT FROM AUTHOR]

Lipoleiomyomas of uterus are uncommon benign neoplasms and are considered to be a variant of uterine myomas are composed of variable proportion of mature lipocytes and smooth muscle cells. These occur in asymptomatic obese perimenopausal or menopausal women. This case of uterine lipoleiomyoma is being presented due to its rarity. [ABSTRACT FROM AUTHOR]

We report on the fabrication and measurement of hydrogen-terminated diamond field-effect transistors (FETs) incorporating V2O5 as a surface acceptor material to induce transfer doping. Comparing a range of gate lengths down to 50 nm, we observe inversely scaling peak output current and transconductance. Devices exhibited a peak drain current of ~700 mA/mm and a peak transconductance of ~150 mS/mm, some of the highest reported thus far for a diamond metal semiconductor FET (MESFET). Reduced sheet resistance of the diamond surface after V2O5 deposition was verified by four probe measurement. These results show great potential for improvement of diamond FET devices through scaling of critical dimensions and adoption of robust transition metal oxides such as V2O5. [ABSTRACT FROM AUTHOR]

Context: There is a paucity of research investigating the association between antenatal care (ANC) attendance and child undernutrition in Madhya Pradesh, India. Aim: To determine whether body weight status in children under the age of 5 years is associated with ANC attendance in Madhya Pradesh. Methods: A cross-sectional study was carried out using data from India's National Family Health Survey (2005–2006). Bodyweight status (an indicator of undernutrition) was determined using weight-for-age. Descriptive statistics and logistic regression were used to estimate prevalence and obtain adjusted odds ratios (AOR) to investigate associations between ANC indicators and weight-for-age. Results: Majority of children were underweight (55.1%). ANC attendance was inadequate, with only 36.8% of women having four or more visits. None of the ANC indicators were associated with body weight status. Increased child age especially an age of 2 years (AOR 2.29; 1.66–3.15), belonging to a scheduled tribe [ST] (AOR 2.36; CI 1.64–3.39), scheduled caste [SC] (AOR 1.75; CI 1.25–2.45) or other backward caste [OBC] (AOR 1.43; CI 1.08–1.89) were associated with being underweight; a birth weight of ≥2.5 kg was associated with lower relative odds of being underweight (AOR 0.43; CI 0.29–0.64). Mothers who had a normal BMI (AOR 0.66; CI 0.53–0.82) or were overweight (AOR 0.42; CI 0.25–0.69) were less likely to have underweight children. Conclusions: ANC attendance was not associated with body weight status. Increased child age, low birth weight, poor maternal nutrition status and belonging to SCs, STs or OBCs increased the odds of child undernutrition. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on 2009 H1N1 infection in a previous issue.

The article focuses on a study by M. E. Pennant et al which reported that the rate of meal-derived glucose appearance in patients with type 1 diabetes is unchanged by administration of prandial insulin 20 minutes before meal ingestion published in the November 2008 issue of "Diabetes Care." It notes that the said finding might have profound implications for affected patients treated with insulin therapy. The authors of the study emphasized that a dual-tracer approach underestimates systemic glucose appearance by 16%.

Hillebrandt, David, Anil Gurtoo, Thomas Kupper, Paul Richards, Volker Schöffl, Pankaj Shah, Rianne van der Spek, Nikki Wallis, and Jim Milledge. UIAA Medical Commission recommendations for mountaineers, hillwalkers, trekkers, and rock and ice climbers with diabetes. High Alt Med Biol. 24: 110–126.—The object of this advice article is not only to give the diabetic mountaineer general guidance but also to inform his or her medical team of practical aspects of care that may not be standard for nonmountaineers. The guidelines are produced in seven sections. The first is an introduction to the guidelines, and the second is an introduction to this medical problem and is designed to be read and understood by diabetic patients and their companions. The third section is for use in an emergency in mountains. The fourth is for rock, ice, and competition climbers operating in a less remote environment. These initial sections are deliberately written in simple language. The fifth and sixth sections are written for clinicians and those with skills to read more technical information, and the seventh looks at modern technology and its pros and cons in diabetes management in a remote area. Sections One and Two could be laminated and carried when in the mountains, giving practical advice. [ABSTRACT FROM AUTHOR]

The article offers information on a study based on effectiveness of dulaglutide noninferior to daily liraglutide for reducing hemoglobin (Hb) A1c levels in patients with uncontrolled type 2 diabetes who are receiving metformin therapy. It mentions that Glucagon-like peptide-1 (GLP-1) analogues can be considered as second- or third-line agents for patients with type 2 diabetes that is poorly controlled despite lifestyle modification and metformin therapy.

The article compares the efficacy of the drugs dulaglutide and liraglutide to metformin treated patients suffering from type-2 diabetes to reduce hemoglobin (Hb) A [1c] levels. It states the exclusion criteria of the study including pancreatitis, higher calcitonin level in serum and cardiovascular (CV) event. It concludes that weekly intake of dulaglutide did not show greater efficacy as compared to daily intake of liraglutide.

Background. To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications. Methods. This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs. During this period, a total of 380 kidney transplantations [71 deceased donor kidney transplantations (DDKTs), 309 LDKTs] were performed. The reasons for opting for KPD were ABO incompatibility (n=45), sensitization (n=26) and better matching (n=6). Results. KPD matching was facilitated in 62% (n=98) of transplants. In all, 48.7% (n=77) of the transplants were completed in 2015, whereas 13.3% (n=21) of the matched patients were to undergo transplant surgery in early 2016 after getting legal permission. The waiting time for KPD was shorter compared with DDKT. The death-censored graft survival and patient survival were 98.7% (n=76) and 93.5% (n=72), respectively. In all, 14.2% (n=11) of patients had acute rejection. Match rates among sensitized (n=60) and O group patients (n=62) were 58.3% (n=35) and 41.9% (n=26), respectively. Of these, 43.3% (n=26) and 29% (n=18) of transplants were completed and 15% (n=9) and 12.9% (n=8), respectively, are waiting for legal permission. Conclusions. LDKT increased by 25% in 1 year in our single-centre KPD programme. Our key to success was the formation of a KPD registry, awareness and active counselling programs and developing a dedicated team. [ABSTRACT FROM AUTHOR]

In a living donor kidney transplantation ( LDKT) dominated transplant programme, kidney paired donation ( KPD) may be a cost-effective and valid alternative strategy to increase LDKT in countries with limited resources where deceased donation kidney transplantation ( DDKT) is in the initial stages. Here, we report our experience of 300 single-centre KPD transplantations to increase LDKT in India. Between January 2000 and July 2016, 3616 LDKT and 561 DDKT were performed at our transplantation centre, 300 (8.3%) using KPD. The reasons for joining KPD among transplanted patients were ABO incompatibility ( n = 222), positive cross-match ( n = 59) and better matching ( n = 19). A total of 124 two-way ( n = 248), 14 three-way ( n = 42), one four-way ( n = 4) and one six-way exchange ( n = 6) yielded 300 KPD transplants. Death-censored graft and patient survival were 96% ( n = 288) and 83.3% ( n = 250), respectively. The mean serum creatinine was 1.3 mg/dl at a follow-up of 3 ± 3 years. We credit the success of our KPD programme to maintaining a registry of incompatible pairs, counselling on KPD, a high-volume LDKT programme and teamwork. KPD is legal, cost effective and rapidly growing for facilitating LDKT with incompatible donors. This study provides large-scale evidence for the expansion of single-centre LDKT via KPD when national programmes do not exist. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease (SCD) is a hereditary blood disorder prevalent in tribal regions of India. SCD can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the community-based hospital of SEWA Rural (Kasturba Maternity Hospital) in Jhagadia block, Gujarat. The objective of the study is to compare the pregnancy outcomes among SCD, sickle cell trait and non-SCD admissions. This study also estimated the risk of adverse pregnancy outcomes for SCD admissions.Methods: The data pertains to four and half years from March 2011 to September 2015. The total tribal maternal admissions were 14640, out of which 10519 admissions were deliveries. The admissions were classified as sickle cell disease, sickle cell trait and non-sickle cell disease. The selected pregnancy outcomes and maternal complications were abortion, stillbirth, Caesarean section, haemoglobin levels, blood transfusion, preterm pregnancy, newborn birth weight and other diagnosed morbidities (IUGR, PIH, eclampsia, preterm labour pain). The odds ratios for each risk factor were estimated for sickle cell patients. The odds ratios were adjusted for the respective years.Results: Overall, 1.2% (131 out of 10519) of tribal delivery admissions was sickle cell admissions. Another 15.6% (1645 out of 10519) of tribal delivery admissions have sickle cell trait. The percentage of stillbirth was 9.9% among sickle cell delivery admission compared to 4.2% among non-sickle cell deliveries admissions. Among sickle cell deliveries, 70.2% were low birth weight compared to 43.8% of non-sickle cell patient. Similarly, almost half of the sickle cell deliveries needed the blood transfusion. The 45.0% of sickle cell delivery admissions were pre-term births, compared to 17.3% in non-SCD deliveries. The odds ratio of severe anaemia, stillbirth, blood transfusion, Caesarean section, and low birth weight was significantly higher for sickle cell admissions compared to non-sickle cell admissions.Conclusions: The study exhibited that there is a high risk of adverse pregnancy outcomes for women with SCD. It may also be associated with the poor maternal and neonatal health in these tribal regions. Thus, the study advocates the need for better management of SCD in tribal Gujarat. [ABSTRACT FROM AUTHOR]

A letter to the editor and a reply are presented in response to the article "Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial," by K. Boutis and colleagues in the 2010 issue.

A letter to the editor is presented related to a study on ketoacidosis during a low-carbohydrate diet in a previous issue.

Wide and ultrawide-bandgap semiconductors lie at the heart of next-generation high-power, high-frequency electronics. Here, we report the growth of ultrawide-bandgap boron nitride (BN) thin films on wide-bandgap gallium nitride (GaN) by pulsed laser deposition. Comprehensive spectroscopic (core level and valence band x-ray photoelectron spectroscopy, Fourier-transform infrared spectroscopy, and Raman) and microscopic (atomic force microscopy and scanning transmission electron microscopy) characterizations confirm the growth of BN thin films on GaN. Optically, we observed that the BN/GaN heterostructure is second-harmonic generation active. Moreover, we fabricated the BN/GaN heterostructure-based Schottky diode that demonstrates rectifying characteristics, lower turn-on voltage, and an improved breakdown capability (∼234 V) as compared to GaN (∼168 V), owing to the higher breakdown electrical field of BN. Our approach is an early step toward bridging the gap between wide and ultrawide-bandgap materials for potential optoelectronics as well as next-generation high-power electronics. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus in kidney transplant recipients is a risk factor for cardiovascular events and premature death. Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) are increasingly used in nontransplant populations to improve diabetes control and cardiovascular and renal benefits. Limited literature exists regarding the safety and efficacy of these agents in renal transplant recipients. Methods: We retrospectively reviewed all kidney transplant recipients within our health system who were prescribed a SGLT2i after transplantation for diabetes. The safety, tolerability, and effectiveness of SGLT2i were analyzed. Results: Thirty‐nine kidney transplant recipients were initiated on SGLT2i therapy, twenty‐seven of which remained on therapy for at least 1 year. Ten (25%) patients experienced an adverse event while on a SGLT2i, with urinary tract infections (UTI) being the most common. Seventeen patients (43%) discontinued the SGLT2i at the time of chart review, most commonly due to cost and kidney function decline. The median [IQR] hemoglobin A1c (HbA1c) at SGLT2i initiation of 8.4% [7.8–9.2] decreased to 7.5% [6.8–8.0%] after 3 months and 7.5% [6.5–7.9] after 12 months. No meaningful change in kidney function or tacrolimus exposure was observed. Conclusion: SGLT2i may be a safe and effective treatment for diabetes in kidney transplant recipients. Cost is a barrier to SGLT2i therapy, and UTIs were the most frequently encountered adverse events in this cohort. More studies are needed to understand the safety profile and determine the effect of SGLT2i on diabetes‐related comorbidities among kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Leveraging nanoscale field-effect transistors (FETs) in integrated circuits depends heavily on its transfer characteristics and low-frequency noise (LFN) properties. Here, we report the transfer characteristics and LFN in FETs fabricated with molybdenum disulfide (MoS2) with different layer (L) counts. 4L to 6L devices showed highest ION-IOFF ratio (108) whereas LFN was maximum for 1L device with normalized power spectral density (PSD) 1.5 × 10-5 Hz-1. For devices with L≈6, PSD was minimum (2 × 10-8 Hz-1). Further, LFN for single and few layer devices satisfied carrier number fluctuation (CNF) model in both weak and strong accumulation regimes while thicker devices followed Hooge's mobility fluctuation model in the weak accumulation regime and CNF model in strong accumulation regime, respectively. Transfer-characteristics and LFN experimental data are explained with the help of model incorporating Thomas-Fermi charge screening and inter-layer resistance coupling. [ABSTRACT FROM AUTHOR]

It is pertinent to have a Tuning Fork Hearing Test that stand-alone can detect severities (Mild, Moderate, Severe and Profound) and the types of hearing losses (Conductive, Sensorineural, and Mixed). A novel 3-Step Tuning Fork Hearing Test (3-STFHT) was attempted for the first time that could detect both the types and the severities of hearing losses. The study was aimed to describe the method of the 3-STFHT and evaluate its clinical utility and reliability. Research Design: Hospital-based observational study of a diagnostic tool. Settings: Otorhinolaryngology Department of a tertiary care medical college hospital. Subjects: 108 adult patients (216 ears) who required hearing evaluation. Main Outcome measures: Sensitivity and specificity of novel 3-STFHT were assessed by comparing its results with the reports of pure tone audiometry in detecting the type and severity of hearing loss. The new 3-STFHT was found very effective (100% sensitivity and specificity) in detecting conductive and profound sensorineural hearing losses. The sensitivity in detecting sensorineural hearing loss was found 97%-100%. The sensitivity was observed relatively low (92%) at detecting mixed hearing loss. The overall sensitivity and specificity of the 3-STFHT in detecting the types of hearing losses was found 97% and 86% respectively. The novel 3-STFHT, which is simple and convenient, was found very effective in detecting the types and severity of hearing losses. The 3-STFHT can be an important tool in otorhinolaryngology practice and in primary care setting for detecting and screening the types and severities of hearing losses. [ABSTRACT FROM AUTHOR]