Healthcare Utilization Survey in the Hybrid Model of the Surveillance for Enteric Fever in India (SEFI) Study: Processes, Monitoring, Results, and Challenges.

BACKGROUND: Lack of reliable data in India drove the "Surveillance of Enteric Fever in India" (SEFI) concept. Hybrid surveillance, combining facility-based surveillance for the crude incidence, and a community-based healthcare utilization survey (HCUS) to calculate the factor needed to arrive at the adjusted incidence, was used in 6 sites. The HCUS aimed to determine the percentage of utilization of study facilities by the catchment population for hospitalizations due to febrile illness. METHODS: Population proportional to size sampling and systematic random sampling, in 2 stages, were used to survey 5000 households per site. Healthcare utilization was assessed. RESULTS: Febrile illness accounted for 20% of admissions among 137 990 individuals from 30 308 households. Only 9.6%-38.3% of those admitted with febrile illness sought care in the study hospitals. The rate of rural utilization of the private sector for hospitalization was 67.6%. The rate of hospitalization for febrile illness, per 1000 population, ranged from 2.6 in Manali to 9.6 in Anantapur; for 25.8% of the deaths associated with febrile illness, no facility was used before death. CONCLUSIONS: One in 5 hospitalizations were associated with fever. Rural utilization of the private sector for hospitalization due to febrile illness was more than that of the public sector. Healthcare utilization patterns for hospital admissions due to febrile illness varied across sites. A meticulously performed HCUS is pivotal for accurate incidence estimation in a hybrid surveillance. CLINICAL TRIALS REGISTRATION: ISRCTN72938224.

Effect of boron supplementation on laying performance of White Leghorn hens fed diet with and without adequate level of calcium.

This study was conducted in White Leghorn layers to ascertain the effect of boron (B) supplementation to calcium (Ca) inadequate diet under standard managemental practices. A total of 80 commercial White Leghorn hens, 25 weeks old with a uniform body weight, were randomly assigned to one of the 4 groups of 20 hens/replicates in each dietary group viz., normal calcium (NC)/Ca adequate, low calcium (LC)/Ca-inadequate, normal calcium with 40 ppm B (NCB) and low calcium with 40 ppm B (LCB). Dietary level of Ca was maintained at two levels, 100 (normal) and 90% (inadequate) of the requirement. Supplementation of B at 40 ppm improved (P < 0.01) egg production of layers from third month of trial as compared to un-supplemented group. Feed conversion ratio of layers was positively (P < 0.05) influenced by B supplementation in Ca-inadequate diet. Egg shell thickness of layers was found to be higher (P < 0.001) in groups supplemented 40 ppm B, irrespective of the level of Ca in the diets. Cracked egg production was also significantly (P < 0.01) lower in B-supplemented groups compared to Ca-inadequate group. Boron supplementation improved Ca retention irrespective of dietary Ca level. Low-Ca diet without boron supplementation resulted in lower retention (P < 0.05) of magnesium and boron. It is concluded that supplementation of 40 ppm B to Ca-inadequate diet ameliorated the lower laying performance in layers and confirms the usefulness of B in such abiotic stress situations.

Findings from the 2017 HIV estimation round & trend analysis of key indicators 2010-2017: Evidence for prioritising HIV/AIDS programme in India.

Background & objectives: The National AIDS Control Organisation (NACO) and the ICMR-National Institute of Medical Statistics, the nodal agency for conducting HIV estimations in India, have been generating HIV estimates regularly since 2003. The objective of this study was to describe India's biennial HIV estimation 2017 process, data inputs, tool, methodology and epidemiological assumptions used to generate the HIV estimates and trends of key indicators for 2010-2017 at national and State/Union Territory levels. Methods: Demographic Projection (DemProj) and AIDS Impact Modules (AIM) of Spectrum 5.63 software recommended by the United Nations Programme on HIV and AIDS Global Reference Group on HIV Estimates, Modelling and Projections, were used for generating HIV estimations on key indicators. HIV sentinel surveillance, epidemiological and programme data were entered into Estimation Projection Package (EPP), and curve fitting was done using EPP classic model. Finally, calibration was done using the State HIV prevalence of two rounds of National Family Health Survey (NFHS) -3 and -4 and Integrated Biological and Behavioural Surveillance (IBBS), 2014-2015. Results: The national adult prevalence of HIV was estimated to be 0.22 per cent in 2017. Mizoram, Manipur and Nagaland had the highest prevalence over one per cent. An estimated 2.1 million people were living with HIV in 2017, with Maharashtra estimated to have the highest number. Of the 88 thousand annual new HIV infections estimated nationally in 2017, Telangana accounted for the largest share. HIV incidence was found to be higher among key population groups, especially people who inject drugs. The annual AIDS-related deaths were estimated to be 69 thousand nationally. For all indicators, geographic variation in levels and trends between States existed. Interpretation & conclusions: With a slow decline in annual new HIV infections by only 27 per cent from 2010 to 2017 against the national target of 75 per cent by 2020, the national target to end AIDS by 2030 may be missed; although at the sub-national level some States have made better progress to reduce new HIV infection. It calls for reinforcement of HIV prevention, diagnosis and treatment efforts by geographical regions and population groups.

Response of in ovo administration of zinc on egg hatchability and immune response of commercial broiler chicken.

An experiment was conducted to determine the effect of in ovo administration of different forms of zinc with respect to hatchability and performance of commercial broiler chicken. In trial 1, the fertile eggs on day 18 were divided into six treatment groups: Group I as control without any supplementation of zinc, group II to IV were supplemented with 0.5 mg zinc per egg as zinc sulphate, zinc methionine or nano zinc, respectively, and Group V with nano zinc at 0.25 mg zinc per egg. Sixth group received 0.5 ml citric acid per egg as sham control. The results of the first trial indicated that in ovo administration of nano zinc at both levels and zinc methionine resulted in complete failure of hatchability. A second trial to validate the result of trial 1 consisted of Group I control (no administration). Group II and Group III were supplemented with zinc sulphate and zinc methionine, respectively, at 0.5 mg zinc per egg. Group IV and Group V were supplemented with nano zinc at 0.04 and 0.08 mg per egg. In the second trial, again there was a similar pattern for zinc sulphate and zinc methionine. Administration of Zn by nano form had around 80% hatchability on fertile eggs in comparison with the unadministered control eggs (92%). There was no difference (p > .05) in body weight gain, feed intake and FCR. No difference (p > .05) was observed between treatments for cell-mediated immune response and humoral immune response. Nano Zn-administered group showed a non-significant downregulation of MUC2 gene. It could be concluded that in ovo administration of higher levels of zinc has to be with caution for the developing embryo of commercial broiler chicken.

Effect of super dosing of phytase on growth performance, ileal digestibility and bone characteristics in broilers fed corn-soya-based diets.

A feeding trial was designed to assess the effect of super dosing of phytase in corn-soya-based diets of broiler chicken. One hundred and sixty-eight day-old broilers were selected and randomly allocated to four dietary treatment groups, with 6 replicates having 7 chicks per treatment group. Two-phased diets were used. The starter and finisher diet was fed from 0 to 3 weeks and 4 to 5 weeks of age respectively. The dietary treatments were consisted of normal phosphorus (NP) group without any phytase enzyme (4.5 g/kg available/non-phytin phosphorus (P) during starter and 4.0 g/kg during finisher phase), three low-phosphorus (LP) groups (3.2 g/kg available/non-phytin P during starter and 2.8 g/kg during finisher phase) supplemented with phytase at 500, 2500, 5000 FTU/kg diet, respectively, to full fill their phosphorus requirements. The results showed that super doses of phytase (at 2500 FTU and 5000 FTU/kg) on low-phosphorus diet improved feed intake, body weight gain, ileal digestibility (serine, aspartic acid, calcium, phosphorus), blood P levels and bone minerals such as calcium (Ca), P, magnesium (Mg) and zinc (Zn) content. It could be concluded that super doses of phytase in low-phosphorus diet were beneficial than the normal standard dose (at 500 FTU/kg) of phytase in diet of broiler chicken.

Meaningful moves: A meaning-based view of nurses' turnover.

Nurses' turnover is a major global problem with significant service and cost implications. Although sizeable research inquiries have been made into the antecedents, the dynamics, and the consequences of nurses' turnover, there is still a lack of fine-grained understanding of the psychological states that reflect the cumulative impact of different antecedents and immediately precede nurses' intentions to quit either from their unit/organization and/or their profession. This paper introduces and develops a meaning-based view of nurses' turnover. This perspective distinguishes between meaning in work (based on the nurses' relationship with their work) and meaning at work (based on the nurses' relationship with their work environment) and explain the implications of high/low meaning in and at work on nurses' turnover. This meaning-based view of nurses' turnover offers nurses, administrators and policy makers a deeper and a more nuanced understanding of turnover and promises more tailored remedies for the turnover problem.

Signaling trustworthiness: The effect of leader humor on feedback-seeking behavior.

Given its capacity to cultivate a range of positive outcomes in the workplace, humor has been recognized as a valuable tool for leadership purposes. However, the theoretical understanding of leader humor remains relatively limited and the mechanism through which it influences follower outcomes has not been clearly identified. Drawing on signaling theory, we developed and empirically tested a model which delineates the relationship between leader humor and a specific follower behavior - proactive feedback seeking. We collected data from 304 employees and their respective leaders working in a large Canadian retail organization. Results of our analyses indicate that leader humor can impact subordinate feedback-seeking behavior via its influence on subordinates' affect-based and cognition-based trust in the leader.

Partial purification and characterization of phytase from Aspergillus foetidus MTCC 11682.

Phytase is a phosphatase enzyme widely used as feed additive to release inorganic phosphorus from plant phytate and enhance its uptake in monogastric animals. Although engineered fungal phytases are used most, a natural enzyme gives opportunity to understand novel properties, if any. In the current study, a novel fungal strain, Aspergillus foetidus MTCC 11682 was immobilized on poly urethane cubes and used for phytase production, purification and molecular characterization. Phytase produced by this method was partially purified by ammonium sulphate precipitation and Sephacryl S-200HR gel filtration to 23.4-fold (compared to crude extract) with recovery of 13% protein. Electrophoresis analysis revealed that phytase has molecular weight of 90.5 kDa on non-reducing and 129.6 kDa on reducing SDS-PAGE. The purified phytase exhibited a wider pH and temperature stability. Analysis of the cloned sequence showed that the gene has 1176 bp that encodes for a peptide of 391 amino acids of the core catalytic region. It was also found that phytase from A. foetidus has a sequence identity of 99% with the phytase gene of other Aspergillus species at nucleotide level and 100% at protein level in A. niger, A. awamori, A. oryzae. In silico analysis of sequence identified the presence of two consecutive and one non-consecutive intra chain disulfide bonds in the phytase. This probably contributed to the differential migration of phytase on reducing and non-reducing SDS-PAGE. There are predicted 11 O-glycosylation sites and 8 N-glycosylation sites, possibly contributed to an enhanced stability of enzyme produced by this organism. This study opened up a new horizon for exploring the novel properties of phytase for other applications.

Green synthesis of a novel flower-like cerium vanadate microstructure for electrochemical detection of tryptophan in food and biological samples.

In this present investigation, we introduced a novel electrochemical sensor for the detection of tryptophan (TRP) based on green pompoms flower-like cerium vanadate (CeVO4). The flower-like CeVO4 microstructure was prepared by the simple hydrothermal treatment with the assistance of urea for the first time. The as-prepared flower-like CeVO4 microstructure was characterized by various analytical and spectroscopic techniques such as X-ray diffraction, Raman spectroscopy fourier transform infrared spectroscopy, scanning electron microscopy and energy-dispersive X-ray spectroscopy studies. The electrochemical properties are evaluated by the cyclic voltammetry (CV) and differential pulse voltammetry (DPV). As an electrochemical sensor, the green pompoms flower-like CeVO4 modified glassy carbon electrode (GCE) displayed an excellent electrocatalytic activity for the detection of TRP. The obtained electrochemical results revealed that the oxidation of TRP, exhibited a lower potential and higher anodic peak current when compared to unmodified GCE. These results were suggested that the flower-like CeVO4/GCE have a good electrocatalytic activity towards the TRP oxidation. The flower-like CeVO4 sensor exhibited the wide linear concentration range and low detection limit of 0.1-94µM and 0.024µM respectively. Finally, the proposed sensor was successfully applied to the determination of TRP in real sample analysis such as food and biological samples with satisfied recoveries.

Biosynthesis of silver nanoparticles by using Camellia japonica leaf extract for the electrocatalytic reduction of nitrobenzene and photocatalytic degradation of Eosin-Y.

In the present study, sphere-like silver nanoparticles (Ag-NPs) were synthesized by using Camellia japonica leaf extract and its remediation industrial pollutants such as nitrobenzene and Eosin-Y (EY). As-prepared sphere-like Ag-NPs were characterized by various analytical and spectroscopic methods such as UV-visible spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), High-resolution transmission electron microscopy (HR-TEM), Energy dispersive X-ray spectra (EDX), and the chemical constituents of the leaf extract were also analyzed by using Gas chromatography and Mass Spectroscopy (GC-MS). Fascinatingly, the as-prepared sphere-like Ag-NPs exhibits excellent electrocatalytic and photocatalytic activity for the reduction of nitrobenzene and photo-degradation of EY dye respectively. The Cyclic voltammetry (CV) and amperometric (i-t) studies realized that the electrochemical behavior of sphere-like Ag-NPs modified electrode on nitrobenzene reduction. The proposed nitrobenzene sensor exhibited appreciable wide linear response range and low detection limit of 0.05-21µM, 23-2593µM and 12nM, respectively. The Ag-NPs modified electrode showed excellent selectivity towards the nitrobenzene detection even in the presence of common metal ions and nitroaromatic containing substances. On the other hand, Ag-NPs have excellent photocatalytic activity with >97% degradation of EY dye after irradiated 60min. These results indicated that the growth of sphere-like Ag-NPs should be a proficient.

Molecular interactions in ethyl acetate-chlorobenzene binary solution: Dielectric, spectroscopic studies and quantum chemical calculations.

Dielectric studies using Time Domain Reflectometry method has been carried out on the binary solution of Ethyl acetate (EA) with Chlorobenzene (CBZ) over the entire composition range. Spectroscopic (FTIR and 13C NMR) signatures of neat EA, CBZ and their equimolar binary solution have also been recorded. The results of the spectroscopic studies favour the presence of (CBZ) CH⋯OC (EA), (EA) methylene CH⋯π electrons (CBZ) and (EA) methyl CH⋯Cl (CBZ) contacts which have been validated using quantum chemical calculations. Dimerization of CBZ has been identified. Presence of ß-clusters has been identified in all the solutions. Although EA and CBZ molecules have nearly equal molar volumes, CBZ molecules experience larger hindrance for the rotation than EA molecules. Very small excess dielectric constant (εE) values may be correlated with weak heteromolecular forces and/or closed heteromolecular association.

A highly sensitive and selective electrochemical determination of non-steroidal prostate anti-cancer drug nilutamide based on f-MWCNT in tablet and human blood serum sample.

A novel electrochemical sensor based on the functionalized multiwalled carbon nanotube (f-MWCNT) was successfully developed for the sensitive and selective determination of non-steroidal prostate anti-cancer drug nilutamide in tablet and blood serum samples. The f-MWCNT was prepared by the simple reflux method and characterized by the scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Raman spectroscopy, X-ray powder diffraction (XRD) and fourier transform infrared spectroscopy (FT-IR). Interestingly, the f-MWCNT was exhibited a superior electrocatalytic activity towards the anti-cancer drug nilutamide when compared with pristine MWCNT and unmodified electrodes. Besides, the electrochemical sensor was revealed an excellent current response for the determination of nilutamide with wide linear ranges (0.01-21µM and 28-535µM), high sensitivity (11.023 and 1.412µA µM-1cm2) and very low detection limit (LOD) 0.2nM. The developed electrochemical sensor was showed an excellent selectivity even in the presence of electrochemically active biological substances and nitro aromatic compounds. Moreover, it manifested a good reproducibility and stability. In addition, the f-MWCNT modified glassy carbon electrode (GCE) sensor was successfully applied for the detection of nilutamide in tablet and blood serum sample.

Phyto mediated biogenic synthesis of gold nanoparticles using Cerasus serrulata and its utility in detecting hydrazine, microbial activity and DFT studies.

Green synthesis of Au-NPs using Cerasus serrulata (C. serrulata) leaves extract has emerged as a nontoxic and ecofriendly option, as compared to currently available chemical and/or physical methods and also Au-NPs act as both reducing and stabilizing agent. The developed Au-NPs were characterized with XRD, UV-visible spectroscopy, FTIR, SEM, TEM and chemical constituents of C. serrulata leaves extract after and before reduction of Au-NPs have been identified through GC-MS. TEM images confirmed that biosynthesized Au-NPs were spherical in shape and approximately in the range of 5-25 nm. The electrochemical results showed remarkable electrocatalytic activity of the Au-NPs-modified GC electrode in the detection of environmentally hazardous pollutant like hydrazine. The modified electrode exhibits a wide linear range 5 nM to 272 µM with low detection limit 0.05 µM. The fabricated sensor shows good selectivity towards other electroactive species as well. Thus the proposed sensor seems to be a potential candidate for developing a simple, rapid and cost-effective electrochemical sensor. The synthesized Au-NPs exhibited higher antibacterial activity against gram negative (Escherichia coli) than gram positive (Staphylococcus aureus) bacteria. DFT studies revealed that the coumarin (CM) present in the C. serrulata leaves extract demonstrated greater reducing and stabilizing properties compared to the properties of other compounds like butylhydroxytoluene (BHT) and hydrocoumarin (HCM) present in the extract.

Green synthesized gold nanoparticles decorated graphene oxide for sensitive determination of chloramphenicol in milk, powdered milk, honey and eye drops.

A simple and rapid green synthesis using Bischofia javanica Blume leaves as reducing agent was developed for the preparation of gold nanoparticles (AuNPs). AuNPs decorated graphene oxide (AuNPs/GO) was prepared and employed for the sensitive amperometric determination of chloramphenicol. The green biosynthesis requires less than 40s to reduce gold salts to AuNPs. The formations of AuNPs and AuNPs/GO were evaluated by scanning electron and atomic force microscopies, UV-Visible and energy dispersive X-ray spectroscopies, X-ray diffraction studies, and electrochemical methods. AuNPs/GO composite film modified electrode was fabricated and shown excellent electrocatalytic ability towards chloramphenicol. Under optimal conditions, the amperometric sensing platform has delivered wide linear range of 1.5-2.95µM, low detection limit of 0.25µM and high sensitivity of 3.81µAµM(-1)cm(-2). The developed sensor exhibited good repeatability and reproducibility, anti-interference ability and long-term storage stability. Practical feasibility of the sensor has been demonstrated in food samples (milk, powdered milk and honey) and pharmaceutical sample (eye drops). The green synthesized AuNPs/GO composite has great potential for analysis of food samples in food safety measures.

Efficacy of a Bacillus sphaericus formulation as influenced by the quality of Culex quinquefasciatus breeding waters.

To understand the physico-chemical factors that influence the efficacy of B. sphaericus formulation in the breeding sites of Culex quinquefasciatus, a study was carried out in Mayiladuturai area of Tamil Nadu (India). The factors studied were hydrogen ion concentration (pH), acidity, alkalinity, chlorides, phosphates, total hardness, sulphates, total solids, dissolved solids, suspended solids, nitrate nitrogen, ammoniacal nitrogen, dissolved oxygen, biological oxygen demand (BOD) and chemical oxygen demand (COD). Efficacy of the formulation was assessed in terms of reduction in larval population in the treated habitats. pH of water in the treated sites was around neutral range (mean +/- SD 7.65 +/- 0.23). Phosphate content was low (2.27 +/- 1.34 ppm) whereas chlorides (326.1 +/- 55.8 ppm) and sulphates (38.9 +/- 23.8 ppm) were high. Total hardness ranged from 206 to 462.5 ppm with a mean of 312.1 +/- 80.5 ppm. The chlorides and sulphates, though present in considerable quantity, did not have any influence on the efficacy of B. sphaericus formulation. However, the proportion of insoluble chlorides and sulphates which contribute to total hardness seemed to influence the formulation adversely.

Efficacy of Bacillus sphaericus in different breeding habitats of Culex quinquefasciatus.

'Spherifix', an alginate based slow release formulation of Bacillus sphaericus was field tested in different types of breeding habitats of Culex quinquefasciatus at the dose of 15 kg ai/ha at bimonthly interval. The efficacy of the formulation was higher in most of the months except in rainy and post-rainy months. The mean percentage reduction +/-SD during the treatment phase of one year was 31.2 +/- 17.9, 50 +/- 29.4, 28.3 +/- 17.6, 30.3 +/- 21.1, 66 +/- 22.5 and 53 +/- 20.4 in larval density and 49 +/- 20.8, 65.1 +/- 26.1, 30.3 +/- 21.9, 59.8 +/- 22.6, 63.1 +/- 21.9 and 47.7 +/- 24.2 in pupal density respectively in cement tanks, cesspools, cesspits, disused wells, unlined drains and cement lined drains. The reduction in immature density was relatively higher in undisturbed, debris free and shallow habitats such as cesspools, unlined drains and cement lined drains. After withdrawal of treatment, the effect of the formulation could be seen for a period of four months.

Modelling epidemiology of leprosy.

A simulation model for leprosy transmission and control has been developed with specific objectives. Several sensitivity experiments have been carried out by altering the various inputs based on empirical data combined with intelligent guessing. The outputs generated through these exercises were on the expected lines. While incremental exercises would improve the model, it can be used even at the existing stage as a tool for programme managers.