Aims/hypothesis
This study reports the results of the first phase of a national study to determine the prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose ...tolerance) in India.
Methods
A total of 363 primary sampling units (188 urban, 175 rural), in three states (Tamilnadu, Maharashtra and Jharkhand) and one union territory (Chandigarh) of India were sampled using a stratified multistage sampling design to survey individuals aged ≥20 years. The prevalence rates of diabetes and prediabetes were assessed by measurement of fasting and 2 h post glucose load capillary blood glucose.
Results
Of the 16,607 individuals selected for the study, 14,277 (86%) participated, of whom 13,055 gave blood samples. The weighted prevalence of diabetes (both known and newly diagnosed) was 10.4% in Tamilnadu, 8.4% in Maharashtra, 5.3% in Jharkhand, and 13.6% in Chandigarh. The prevalences of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were 8.3%, 12.8%, 8.1% and 14.6% respectively. Multiple logistic regression analysis showed that age, male sex, family history of diabetes, urban residence, abdominal obesity, generalised obesity, hypertension and income status were significantly associated with diabetes. Significant risk factors for prediabetes were age, family history of diabetes, abdominal obesity, hypertension and income status.
Conclusions/interpretations
We estimate that, in 2011, Maharashtra will have 6 million individuals with diabetes and 9.2 million with prediabetes, Tamilnadu will have 4.8 million with diabetes and 3.9 million with prediabetes, Jharkhand will have 0.96 million with diabetes and 1.5 million with prediabetes, and Chandigarh will have 0.12 million with diabetes and 0.13 million with prediabetes. Projections for the whole of India would be 62.4 million people with diabetes and 77.2 million people with prediabetes.
Background: Telemedicine, an evolving technology in India's healthcare sector, offers promising avenues for improving healthcare accessibility and delivery. Its successful implementation relies on ...several factors, including the comprehension of its concepts, skill acquisition, attitude toward technology, and conducive work environments among healthcare professionals. Despite the pressing need for enhanced healthcare in developing countries like India, telemedicine remains more advanced in developed nations. The objective of this study was to evaluate the knowledge, attitude, and perceived barriers to telemedicine among medical professionals at government medical college Trivandrum and KIMS health Trivandrum. Methods: A cross-sectional survey involving 150 medical professionals across various departments was conducted using a structured questionnaire via the Kobo toolbox, an online survey tool. The collected data were analyzed to assess the understanding of telemedicine, attitudes toward its adoption, and barriers encountered by respondents. Results: The analysis revealed that while a commendable 35.3% of respondents exhibited a good understanding of telemedicine, the majority 64.7% lacked sufficient knowledge in this domain. However, there was a positive disposition towards telemedicine adoption, with 64.7% displaying strong positive attitudes, 24.7% expressing moderate attitudes, and 10.7% indicating lower inclinations. Notably, human resource availability emerged as the most prevalent barrier, while sustainable practices were cited least frequently. Conclusions: While many medical professionals showed support for telemedicine, their knowledge was limited, and the study identified multiple barriers to its adoption. Urgent action is needed to narrow the disparity between telemedicine's potential and its actual use in India's healthcare system.
Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal-dominant disorder characterized by progressive and profoundly disabling heterotopic ossification (HO). Here we show that ...fibro/adipogenic progenitors (FAPs) are a major cell-of-origin of HO in an accurate genetic mouse model of FOP (Acvr1
). Targeted expression of the disease-causing type I bone morphogenetic protein (BMP) receptor, ACVR1(R206H), to FAPs recapitulates the full spectrum of HO observed in FOP patients. ACVR1(R206H)-expressing FAPs, but not wild-type FAPs, activate osteogenic signaling in response to activin ligands. Conditional loss of the wild-type Acvr1 allele dramatically exacerbates FAP-directed HO, suggesting that mutant and wild-type ACVR1 receptor complexes compete for activin ligands or type II BMP receptor binding partners. Finally, systemic inhibition of activin A completely blocks HO and restores wild-type-like behavior to transplanted Acvr1
FAPs. Understanding the cells that drive HO may facilitate the development of cell-specific therapeutic approaches to inhibit catastrophic bone formation in FOP.
Interannual sea level anomalies (SLA), and the related thermocline variations, along the west coast of India (WCI) strongly impact the ecosystems, fisheries, and potentially the monsoon rainfall. ...Here we investigate the mechanisms driving the WCI interannual SLA using a linear continuously stratified ocean model, which realistically simulates the leading northern Indian Ocean SLA mode associated with the Indian Ocean Dipole (IOD). During, for example, positive IOD events, easterly wind anomalies near Sri Lanka in late summer and fall force downwelling coastal Kelvin waves, which induce positive WCI SLA within days. Meanwhile, equatorial easterlies force upwelling Kelvin waves that travel to WCI through the Bay of Bengal coastal waveguide. Part of this opposite signal also transits slowly through the Bay of Bengal interior as Rossby waves, eventually yielding negative SLA along the WCI in winter. The WCI SLA thus shifts from positive in fall to negative in winter during positive IOD events.
Plain Language Summary
The Indian Ocean Dipole (IOD) is the leading mode of Indian Ocean climate variability and is associated with anomalous winds over the equatorial Indian Ocean. A recent work has demonstrated that IOD events could strengthen or inhibit the upwelling of poorly oxygenated waters along the west coast of India (WCI). Such an upwelling impacts oxygen distribution in the upper layers and can thus have adverse effects on ecosystem and fisheries. Here we explain the mechanisms linking the IOD to upwelling along the WCI. IOD zonal winds in the central equatorial Indian Ocean produce two opposite signals on WCI. One that travels fast, directly up the WCI during summer and fall. But another opposite‐polarity signal follows equator and Bay of Bengal rim—a part of which transits slowly through the Bay of Bengal interior, eventually reaching the WCI and flipping the sign of sea level anomalies there in winter.
Key Points
Positive Indian Ocean Dipoles induce positive (negative) sea level anomalies in boreal fall (winter) along the west coast of India
Fall easterly wind anomalies near Sri Lanka force downwelling coastal Kelvin waves that travel quickly to the west coast of India
Fall eastern equatorial upwelling signals travel more slowly through the interior Bay of Bengal, reaching the Indian west coast in winter
A Road Map to IndOOS-2 Beal, L. M.; Vialard, J.; Roxy, M. K. ...
Bulletin of the American Meteorological Society,
11/2020, Volume:
101, Issue:
11
Journal Article
Peer reviewed
Open access
The Indian Ocean Observing System (IndOOS), established in 2006, is a multinational network of sustained oceanic measurements that underpin understanding and forecasting of weather and climate for ...the Indian Ocean region and beyond. Almost one-third of humanity lives around the Indian Ocean, many in countries dependent on fisheries and rain-fed agriculture that are vulnerable to climate variability and extremes. The Indian Ocean alone has absorbed a quarter of the global oceanic heat uptake over the last two decades and the fate of this heat and its impact on future change is unknown. Climate models project accelerating sea level rise, more frequent extremes in monsoon rainfall, and decreasing oceanic productivity. In view of these new scientific challenges, a 3-yr international review of the IndOOS by more than 60 scientific experts now highlights the need for an enhanced observing network that can better meet societal challenges, and provide more reliable forecasts. Here we present core findings from this review, including the need for 1) chemical, biological, and ecosystem measurements alongside physical parameters; 2) expansion into the western tropics to improve understanding of the monsoon circulation; 3) better-resolved upper ocean processes to improve understanding of air–sea coupling and yield better subseasonal to seasonal predictions; and 4) expansion into key coastal regions and the deep ocean to better constrain the basinwide energy budget. These goals will require new agreements and partnerships with and among Indian Ocean rim countries, creating opportunities for them to enhance their monitoring and forecasting capacity as part of IndOOS-2.
The response of the Indian winter monsoon to climate change has received considerably less attention than that of the summer monsoon. We show here that all Coupled Model Intercomparison Project Phase ...5 (CMIP5) models display a consistent reduction (of 6.5% for Representative Concentration Pathways 8.5 and 3.5% for 4.5, on an average) of the winter monsoon winds over the Arabian Sea at the end of 21st century. This projected reduction weakens but remains robust when corrected for overestimated winter Arabian Sea winds in CMIP5. This weakening is driven by a reduction in the interhemispheric sea level pressure gradient resulting from enhanced warming of the dry Arabian Peninsula relative to the southern Indian Ocean. The wind weakening reduces winter oceanic heat losses to the atmosphere and deepening of convective mixed layer in the northern Arabian Sea and hence can potentially inhibit the seasonal chlorophyll bloom that contributes substantially to the Arabian Sea annual productivity.
Plain Language Summary
The Indian summer monsoon response to climate change has been previously the focus of many studies. The Indian winter monsoon‐projected response to climate change is, however, largely unexplored. This is the first study to report a robust weakening of the Indian winter monsoon winds over the Arabian Sea in two Coupled Model Intercomparison Project Phase 5 scenarios (an unmitigated and a mitigated one). The wind weakening leads to reduced winter oceanic convective overturning in the northern Arabian Sea. This winter convection is the key mechanism for a productivity (winter) bloom that strongly contributes to the Arabian Sea annual productivity. The projected winter monsoon weakening may thus reduce the Arabian Sea productivity. We also show a rainfall increase that could affect water supply in tropical Indian Ocean islands and Eastern Africa.
Key Points
This study reports a robust reduction of the northeast monsoon winds over the Arabian Sea under two climate change scenarios
The wind weakening is driven by a reduction of the Interhemispheric sea level pressure gradient
Weakening of winds leads to a reduced winter mixed layer deepening in the northern Arabian Sea and hence less oceanic productivity
We report previously undetermined interstellar gas and dust-phase carbon abundances along 15 Galactic sight lines based on archival data of the strong 1334.5323 A transition observed with the Space ...Telescope Imaging Spectrograph. These are combined with previously reported carbon measurements along six sight lines to produce a complete sample of interstellar C II measurements determined with the 1334 A transition. Our data set includes a variety of Galactic disk environments characterized by different extinctions and samples paths ranging over three orders of magnitude in average density of hydrogen (left angle bracketn(H)right angle bracket). Our data support the idea that dust, specifically carbon-based grains, are processed in the neutral interstellar medium. We, however, do not find that the abundance of carbon in dust or the grain-size distribution is related to the strength of the 2175 A bump. This is surprising, given that many current models have polycyclic aromatic hydrocarbons as the bump-producing dust.
The objective of this study was to evaluate the sonographic findings of inflammatory bowel disease activity in children undergoing treatment.
Eighty-eight sonograms were obtained of 23 bowel segments ...in 17 children and young adults (age range, 10-21 years; mean, 16 years) with new or recurrent inflammatory bowel disease. Sixteen segments were involved with Crohn's disease and seven with ulcerative colitis. Serial sonography (range, two to eight examinations; mean, four per segment) was performed while patients underwent treatment. Bowel wall thickness measurements and color and power Doppler sonography grading were recorded and compared with clinical data.
All 17 patients had at least one abnormal bowel segment on initial sonography. The correlation was significant (p < 0.01). Agreement was 91% on direction of change over time between bowel wall thickness and Doppler grades, with 100% correlation between color and power Doppler sonography grades. In patients with Crohn's disease, the correlation was significant (p < 0.05) between bowel wall thickness and Doppler grades with two of seven and four of seven clinical parameters, respectively. In patients with ulcerative colitis, the correlation was significant (p < 0.05) between bowel wall thickness and Doppler sonography grades with four of seven and three of seven clinical parameters, respectively. The erythrocyte sedimentation rate correlated with all sonographic measurements in both patient groups. Combining bowel wall thickness and Doppler sonography, the percentage of agreement was significant in the direction of change, with five of seven clinical parameters in both patient groups.
Gray-scale and color or power Doppler sonography can show changes in disease activity in children and young adults undergoing treatment for inflammatory bowel disease.
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disease characterized by progressive and catastrophic heterotopic ossification (HO) of skeletal muscle and associated soft tissues. FOP ...is caused by dominantly acting mutations in the gene encoding the bone morphogenetic protein (BMP) type I receptor, ACVR1 (ALK2), the most prevalent of which results in an arginine to histidine substitution at position 206 (ACVR1R206H). The fundamental pathological consequence of FOP-causing ACVR1 receptor mutations is to enable activin A to initiate canonical BMP signaling in fibro-adipogenic progenitors (FAPs), which drives HO. We developed a monoclonal blocking antibody (JAB0505) against the extracellular domain of ACVR1 and tested its effect on HO in 2 independent FOP mouse models. Although JAB0505 inhibited BMP-dependent gene expression in wild-type and ACVR1(R206H)-overexpressing cell lines, JAB0505 treatment profoundly exacerbated injury-induced HO. JAB0505-treated mice exhibited multiple, distinct foci of heterotopic lesions, suggesting an atypically broad anatomical domain of FAP recruitment to endochondral ossification. This was accompanied by dysregulated FAP population growth and an abnormally sustained immunological reaction following muscle injury. JAB0505 drove injury-induced HO in the absence of activin A, indicating that JAB0505 has receptor agonist activity. These data raise serious safety and efficacy concerns for the use of bivalent anti-ACVR1 antibodies to treat patients with FOP.
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•Silver and activated carbon co-doped titania nanoparticles (TAC) were synthesized.•Pure anatase phase titania, face centered cubic silver nanoparticles were observed.•Zones of ...inhibition comparable to streptomycin were observed in E. coli & S. aureus.•Adsorptive nature of activated carbon concentrates bacteria around TAC.•Oxidative stress, cell rupture and bacterial adsorption inhibit bacterial growth.
Development of efficient antimicrobial agents is imperative for the persistent microbial pollution and contamination. Here, we have analyzed the enhancement in the antibacterial activity of TiO2 nanoparticles when co-doped with silver nanoparticles (Ag NPs) and activated carbon (TAC). Highly active anatase phased TiO2 was observed in X-ray diffraction patterns and Raman spectra. Morphological studies revealed the formation of spherical TiO2 and Ag NPs on carbonaceous sheets. The gram negative bacterium, E. coli and gram positive bacterium S. aureus showed zones of inhibition of 7 mm which was comparable to the standard, streptomycin. This inhibitory activity is due synergistic effects of activated carbon, Ag NPs and TiO2 in the nanocomposite. The adsorption ability of activated carbon concentrates the bacteria around the nanoparticle environment. The oxidative stress and cell wall rupture brought about by Ag+ ions and TiO2 respectively inhibit the growth of the concentrated bacteria. The cost-effective and lethal nature of TAC towards both gram positive and gram negative bacterium may find numerous applications in antibacterial coatings, paints, surfaces and films.
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