Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review.

BACKGROUND: Fragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. This systematic review aims to identify the effectiveness of system navigation programs linking primary care with community-based health and social services to improve patient, caregiver, and health system outcomes. METHODS: Building on a previous scoping review, PsychInfo, EMBASE, CINAHL, MEDLINE, and Cochrane Clinical Trials Registry were searched for intervention studies published between January 2013 and August 2020. Eligible studies included system navigation or social prescription programs for adults, based in primary care settings. Two independent reviewers completed study selection, critical appraisal, and data extraction. RESULTS: Twenty-one studies were included; studies had generally low to moderate risk of bias. System navigation models were lay person-led (n = 10), health professional-led (n = 4), team-based (n = 6), or self-navigation with lay support as needed (n = 1). Evidence from three studies (low risk of bias) suggests that team-based system navigation may result in slightly more appropriate health service utilization compared to baseline or usual care. Evidence from four studies (moderate risk of bias) suggests that either lay person-led or health professional-led system navigation models may improve patient experiences with quality of care compared to usual care. It is unclear whether system navigation models may improve patient-related outcomes (e.g., health-related quality of life, health behaviours). The evidence is very uncertain about the effect of system navigation programs on caregiver, cost-related, or social care outcomes. CONCLUSIONS: There is variation in findings across system navigation models linking primary care with community-based health and social services. Team-based system navigation may result in slight improvements in health service utilization. Further research is needed to determine the effects on caregiver and cost-related outcomes.

Complimentary effect of exogenous enzymes, essential amino acids and essential fatty acids supplemented de-oiled rice bran (DORB) based diets on hematology, liver and intestinal histoarchitecture in Labeo rohita.

A 60-day feeding trial was conducted to study the hematology, liver, and intestinal histoarchitecture of Labeo rohita fed with a combination of exogenous enzymes, essential amino acids, and essential fatty acids to DORB (De-oiled rice bran) based diets. Three treatments viz., T1 [DORB + phytase and xylanase (0.01% each)], T2 [DORB + phytase (0.01%) + xylanase (0.01%) + L-lysine(1.4%) + L-methionine (0.4%) + EPA and DHA (0.5%)] and T3 [DORB + phytase (0.01%), xylanase and cellulase (0.075%) + L-lysine (1.4%) +L-methionine (0.4%) + EPA and DHA (0.5%)] were used in the present study. Serum total protein, albumin content and A/G ratio varied significantly (p < 0.05) among groups. Globulin content did not vary significantly among groups (p ≥ 0.05). The Hb content, RBC and MCV count varied significantly (p < 0.05) whereas MCH, MCHC content, WBC and lymphocyte count did not vary significantly among groups (p > 0.05). The liver and intestine examination revealed no visible alteration and showed normal histo-architecture. Based on the finding it is concluded that DORB supplemented with exogenous enzymes, essential amino acids and essential fatty acids with phytase (0.01%), xylanase and cellulase (0.075%), L-lysine (1.4%), DL-methionine (0.4%) and EPA and DHA (0.5%) improves the health of L. rohita.

Road Condition Monitoring Using Smart Sensing and Artificial Intelligence: A Review.

Road condition monitoring (RCM) has been a demanding strategic research area in maintaining a large network of transport infrastructures. With advancements in computer vision and data mining techniques along with high computing resources, several innovative pavement distress evaluation systems have been developed in recent years. The majority of these technologies employ next-generation distributed sensors and vision-based artificial intelligence (AI) methodologies to evaluate, classify and localize pavement distresses using the measured data. This paper presents an exhaustive and systematic literature review of these technologies in RCM that have been published from 2017-2022 by utilizing next-generation sensors, including contact and noncontact measurements. The various methodologies and innovative contributions of the existing literature reviewed in this paper, together with their limitations, promise a futuristic insight for researchers and transport infrastructure owners. The decisive role played by smart sensors and data acquisition platforms, such as smartphones, drones, vehicles integrated with non-intrusive sensors, such as RGB, and thermal cameras, lasers and GPR sensors in the performance of the system are also highlighted. In addition to sensing, a discussion on the prevalent challenges in the development of AI technologies as well as potential areas for further exploration paves the way for an all-inclusive and well-directed futuristic research on RCM.

Exogenous phytase and xylanase supplementation of formulated diets for rohu (Labeo rohita): impact on haematology, histology and IGF I gene expression.

The present study aims to delineate the effect of exogenous enzyme supplementation of fermented or non-fermented de-oiled rice bran (DORB) on haematology, histology and expression of IGF I gene expression of Labeo rohita. Four test diets, namely, T1 (DORB), T2 (fermented DORB), T3 (DORB+exogenous enzyme) and T4 (fermented DORB+exogenous enzyme) were formulated and fed to the L. rohita for a period of 60 days. The test diets T3 and T4 were supplemented with 0.1 g kg-1 xylanase (16,000 U kg-1) and 0.1 g kg-1 phytase (500 U kg-1) enzymes. A total of 120 juveniles of L. rohita (average weight 5.01 ± 0.02 g) were stocked in 12 rectangular tanks with 10 fish per tank in triplicates. At the end of the experiment, haematology, histology and IGF I gene expression of the different groups were analysed. The haemoglobin (Hb) content, RBC count and WBC count of L. rohita varied significantly (p < 0.05) among different groups. T3 diet-fed group had the highest Hb content, RBC count and WBC count as compared to the other groups. The MCV content was significantly (p < 0.05) lower in T3 group. The DORB type, exogenous enzyme supplementation and their interaction have no significant (p > 0.05) effect on MCH, MCHC and lymphocyte content of the cultured fish. The group which were fed T3 diet had significantly (p < 0.05) higher IGF-I gene expression as compared to other groups. The histological examination of liver revealed no pathological alteration of this organ. Similarly, there were no pathological changes observed in intestinal tissue in any dietary treatment group. Based on the findings of the present study, it is concluded that exogenous enzyme supplementation of DORB-based diets improves the physiological status and growth performances of Labeo rohita.

Comparative evaluation of fermented and non-fermented de-oiled rice bran with or without exogenous enzymes supplementation in the diet of Labeo rohita (Hamilton, 1822).

A 60-day feeding trial was conducted to study the effect of exogenous enzymes (xylanase and phytase) supplementation in the non-fermented and fermented de-oiled rice bran (DORB)-based diet of Labeo rohita. Four test diets (T1-DORB-based diet, T2-fermented DORB-based diet, T3-phytase and xylanase supplemented DORB-based diet, and T4-phytase and xylanase supplemented fermented DORB-based diet) were formulated and fed to the respective groups. Test diets T3 and T4 were supplemented with 0.01% xylanase (16,000 U kg-1) and 0.01% phytase (500 U kg-1) enzymes. One hundred twenty juveniles of L. rohita, with an average weight 5.01 ± 0.02 g, were stocked in 12 uniform size plastic rectangular tanks in triplicate with 10 fishes per tank following a completely randomized design (CRD). Exogenous enzyme supplementation to the T3 group significantly improved the growth performance of L. rohita (p < 0.05). Fermented DORB fed groups registered significantly lower growth irrespective of the supplementation of exogenous enzymes. The carcass composition (except CP %), enzyme activities (except amylase activity), globulin, and A/G ratio did not vary significantly (p > 0.05). Based on the results of the present study, it is concluded that exogenous enzyme supplementation significantly increases the growth of fish fed with DORB-based diet.

The amino-terminal domain of ELL transcription elongation factor is essential for ELL function in Schizosaccharomyces pombe.

Transcriptional elongation is a critical step for regulating expression of protein-coding genes. Multiple transcription elongation factors have been identified in vitro, but the physiological roles of many of them are still not clearly understood. The ELL (Eleven nineteen Lysine rich Leukemia) family of transcription elongation factors are conserved from fission yeast to humans. Schizosaccharomyces pombe contains a single ELL homolog (SpELL) that is not essential for its survival. Therefore to gain insights into the in vivo cellular functions of SpELL, we identified phenotypes associated with deletion of ell1 in S. pombe. Our results demonstrate that SpELL is required for normal growth of S. pombe cells. Furthermore, cells lacking ell1+ exhibit a decrease in survival when exposed to DNA-damaging conditions, but their growth is not affected under environmental stress conditions. ELL orthologs in different organisms contain three conserved domains, an amino-terminal domain, a middle domain and a carboxyl-terminal domain. We also carried out an in vivo functional mapping of these conserved domains within S. pombe ELL and uncovered a critical role for its amino-terminus in regulating all its cellular functions, including growth under different conditions, transcriptional elongation potential and interaction with S. pombe EAF. Taken together our results suggest that the domain organization of ELL proteins is conserved across species, but the in vivo functions as well as the relationship between the various domains and roles of ELL show species-specific differences.

Analyzing Joshimath's sinking: causes, consequences, and future prospects with remote sensing techniques.

The Himalayas are highly susceptible to various natural disasters, such as the tectonically induced land deformation, earthquakes, landslides, and extreme climatic events. Recently, the Joshimath town witnessed a significantly large land subsidence activity. The phenomenon resulted in the development of large cracks in roads and in over 868 civil structures, posing a significant risk to inhabitants and infrastructure of the area. This study uses a time-series synthetic aperture radar (SAR) interferometry-based PSInSAR approach to monitor land deformation utilizing multi-temporal Sentinel-1 datasets. The line of sight (LOS) land deformation velocity for the Joshimath region, calculated for the year 2022-2023 using a PSInSAR-based approach, varies from - 89.326 to + 94.46 mm/year. The + ve sign indicates the LOS velocity/displacement away from the SAR sensor, whereas - ve sign signifies the earth's movement towards the SAR sensor in the direction of LOS. In addition, the study investigates feature tracking land displacement analysis using multi-temporal high-resolution Planet datasets. The result of this analysis is consistent with the PSInSAR results. The study also estimated the land deformation for the periods 2016-2017, 2018-2019, and 2020-2021 separately. Our results show that the Joshimath region experienced the highest land deformation during the year 2022-2023. During this period, the maximum land subsidence was observed in the north-western part of the town. The maximum LOS land deformation velocity + 60.45 mm/year to + 94.46 mm/year (2022-2023), occurred around Singhdwar, whereas the north and central region of the Joshimath town experienced moderate to high subsidence of the order of + 10.45 mm/year to + 60.45 mm/year (2022-2023), whereas the south-west part experienced an expansion of the order of 84.65 mm/year to - 13.13 mm/year (2022-2023). Towards the south-east, the town experienced rapid land subsidence, - 13.13 mm/year to - 5 mm/year (2022-2023). The study analyzes the causative factors of the observed land deformation in the region. Furthermore, this work assesses the ground conditions of the Joshimath region using UAV datasets acquired in the most critically affected areas such as Singhdhaar, Hotel Mountain View, Malhari Hotel, and Manoharbagh. Finally, the study provides recommendations and future prospects for the development policies that need to be adopted in the critical Himalayan regions susceptible to land deformation. The study suggests that land deformation in the region is primarily attributed to uncontrolled anthropogenic activities, infrastructural development, along with inadequate drainage systems.

Evaluating the impact of engaging older adults and service providers as research partners in the co-design of a community mobility-promoting program: a mixed methods developmental evaluation study.

BACKGROUND: Increasingly researchers are partnering with citizens and communities in research; less is known about research impacts of this engagement. EMBOLDEN is an evidence-informed, mobility-promoting intervention for older adults co-designed by a 26-person Strategic Guiding Council (SGC) of health/social service providers and older adult citizens. This study evaluated research partners' perceptions of engagement strategies, the engagement context, strengths, areas for improvement, as well as the impacts of the guiding council on older-adult identified priority areas. METHODS: This study was guided by developmental evaluation, working in partnership with four older adult SGC members who helped to set evaluation priorities, decide methods, and adapt patient-centred evaluation tools. Data sources included a questionnaire, focus groups and document analysis of meeting notes from 16 SGC meetings that took place between December 2019 and February 2022. A thematic approach to analysis guided the coding of focus group transcripts and SGC meeting notes. Convergent mixed methods guided the integration and presentation of qualitative and quantitative data sources in a joint display of evaluation results. RESULTS: Of 26 SGC members, nine completed the evaluation squestionnaire, and five participated in focus groups. Around two thirds of the SGC commonly attended each meeting. EMBOLDEN's SGC was structured to include a diverse group (across gender, ethnicity and discipline) of older adults and service providers, which was perceived as a strength. Engagement processes were perceived as inclusive and well-facilitated, which stimulated discussion at meetings. Advantages and disadvantages of engaging with the SGC virtually, as compared to in-person (as was the case for the first 3 SGC meetings) were also discussed. Impacts of the SGC were identified across preparatory, execution phase and translational stages of research. Impacts of SGC involvement on members were also described. CONCLUSION: Older adult research partners played an important role designing, implementing, and evaluating co-design approaches in this study. Older adults and service providers can make important contributions to the design, delivery and sharing results of health research through their lived expertise and connections to community. This project contributes to the growing field of citizen and community engagement in research by offering a participatory approach to engagement evaluation that considers diversity, satisfaction, and impact.

It is becoming common for researchers to ask patients and caregivers to become involved with their studies as partners. By partnering with people who have first-hand experience with a condition, researchers hope their studies will be more relevant, run efficiently and have more impact than studies designed by researchers alone. Over the last twenty years, there has been a significant increase in the number of published papers that involve patients and caregivers, but few papers mention what changed because of this involvement. Researchers need to know the best ways to involve patients and caregivers and the impact of doing so.This study aimed to find out how a council of older adults (OAs) and service providers (SPs) impacted a study about collaboratively designing and testing a mobility intervention. This study aimed to find out how council members felt about their involvement in this study, by asking them what went well and what could have been improved.This study used a questionnaire, focus groups and analyzed council meeting notes to inform this study. Four OA council members helped design the study, decide research methods, and adapt wording of questions (focus groups, questionnaire). Between 19% and 35% of council members completed evaluation activities. They felt the study strengths were the diversity of the council, and a welcoming environment for discussion. The council impacted how the study was designed, carried out and how results were shared. Results from this study can improve patient partnership engagement, experiences, and impacts in future studies.

A Hidden "Suspender" in Irreducible Isolated Anteromedial Radial Head Dislocations - A Case Report and Review.

Introduction: Isolated anteromedial radial head dislocations are rare and are infrequently associated with hidden musculotendinous sling of superficial brachialis or biceps tendon impeding closed reduction. Failure to identify this impeding tendon can lead an unsuccessful and unstable open reduction surgery. This is the first case of its kind where the delayed presenting patient was treated without resection of the tendon. Case Report: We describe a case of an irreducible neglected isolated anteromedial radial head dislocation in a 7-year-old male child presenting 2 months following injury with features of active heterotrophic ossification (HO). Open surgical exploration 4 months following the injury through the Boyd's approach revealed a hidden musculotendinous sling of superficial brachialis suspending the radial head anteromedially. Releasing the adhesions and relocation of the tendon allowed spontaneous radiocapitellar joint reduction. The joint congruency was maintained at 18 months and the functional outcome was excellent with a mild flexion-pronation deficit. Conclusion: Awareness of the rare impeding biceps/brachialis tendinous sling in cases of isolated anteromedial radial head dislocation can guide the surgeon to order an indicated preoperative magnetic resonance imaging and plan an early open reduction. HO may occur frequently with such an injury considering the severity of the associated soft-tissue injury.

Biometric Indices, Physio-Metabolic Responses and Carcass Quality in Rohu (Labeo rohita) during Feed Deprivation.

Understanding changes in biometric indices and metabolism in fish exposed to feed deprivation may be useful in aquaculture. The present study elucidates the effect of feed deprivation on physio-biochemical responses, such as changes in biometric indices, nutrient mobilization patterns, and enzyme activities in rohu (Labeo rohita). Experimental fish (av. wt. 3.41 ± 0.07 g) were deprived of feed and sampled at intervals of 0, 15, 30, 45, and 60 days to measure weight, length, body composition, and the activities of enzymes involved in digestion, metabolism, and antioxidation. A decrease in body weight, condition factor (CF), hepatosomatic index (HSI), and gastrosomatic index (GSI) was observed during the initial stage of feed deprivation (15 to 30 days) but remained unchanged thereafter. The total carbohydrate and lipid content also decreased rapidly up until 30 days, then stabilized. However, the reduction in tissue protein content (% wet weight) continued gradually with the duration of feed deprivation from 12.85 ± 0.36 at 0 days to 10.04 ± 0.67 at 15 days, 8.79 ± 0.59 at 30 days, 6.95 ± 0.69 at 45 days, and 6.16 ± 0.8 at 60 days, which was lower, compared to the other two body constituents. Amylase, protease. and lipase activities significantly reduced up until 30 days, but then stabilized. Although G6PDH enzyme activity decreased, gluconeogenic (LDH, AST, and ALT) and antioxidative (SOD and catalase) enzyme activities increased during initial feed deprivation (up to 30 days). A tissue-specific difference in amino acid metabolism with a major role of ALT in liver and AST in muscle was observed. This study revealed that rohu fingerlings adapted well to feed deprivation up until 30 days, beyond which there was an overall deterioration in the metabolic functions.

Analyzing urbanization induced groundwater stress and land deformation using time-series Sentinel-1 datasets applying PSInSAR approach.

Urban intensification has taken a serious toll on the groundwater reserves which is one of the primary sources of fresh water on earth. Exploitation of groundwater has exponentially increased over time, especially in urban landscapes, with ever increasing demands to cater the growing population and development processes. This emphasizes on the importance of proper monitoring of the groundwater variations, which is a difficult process for not being directly accessible for physical measurements. Therefore, it is essential to develop advanced innovative indirect methods to help long-term monitoring of groundwater reserves at a relatively higher resolution, so that local level variations and their impact could be studied in case of excessively exploited zones, like cities. Recent studies have linked land-subsidence to over-exploitation of groundwater, which can be critical for urban scenario, which requires longer duration for replenishment. Thus, this study focuses on monitoring of the groundwater variations using time-series Sentinel-1 Interferometric SAR (InSAR) datasets by retrieving land deformation by PsInSAR (Persistent Scatterer Interferometric SAR) technique; applying phase information of permanent scattering candidates. 58 and 60 images were acquired during ascending and descending passes respectively between 9/10/2014 to 2/7/2020 for the study area i.e., Lucknow city (India) and its surroundings. The field measurements of groundwater level for various seasons (pre and post monsoons) were acquired from the Central Groundwater Board, Government of India (CGWB). Besides, Landsat 5 and 8 datasets were utilized to analyze the pattern of urban growth for a 30-year period and predict the near future scenario. In-depth analysis of all the components revealed a direct relationship between land deformation, groundwater variations and urban expansion. A high correlation coefficient of 0.886 was observed between groundwater level variation and the retrieved deformation measured along the groundwater wells along the deformation zones. Therefore, the overall analysis and results indicate that PsInSAR technique has great potential for estimating the groundwater levels and surface deformation at higher resolution and could be easily applied for any other city for continuous assessment.

EpiDBase: a manually curated database for small molecule modulators of epigenetic landscape.

We have developed EpiDBase (www.epidbase.org), an interactive database of small molecule ligands of epigenetic protein families by bringing together experimental, structural and chemoinformatic data in one place. Currently, EpiDBase encompasses 5784 unique ligands (11 422 entries) of various epigenetic markers such as writers, erasers and readers. The EpiDBase includes experimental IC(50) values, ligand molecular weight, hydrogen bond donor and acceptor count, XlogP, number of rotatable bonds, number of aromatic rings, InChIKey, two-dimensional and three-dimensional (3D) chemical structures. A catalog of all epidbase ligands based on the molecular weight is also provided. A structure editor is provided for 3D visualization of ligands. EpiDBase is integrated with tools like text search, disease-specific search, advanced search, substructure, and similarity analysis. Advanced analysis can be performed using substructure and OpenBabel-based chemical similarity fingerprints. The EpiDBase is curated to identify unique molecular scaffolds. Initially, molecules were selected by removing peptides, macrocycles and other complex structures and then processed for conformational sampling by generating 3D conformers. Subsequent filtering through Zinc Is Not Commercial (ZINC: a free database of commercially available compounds for virtual screening) and Lilly MedChem regular rules retained many distinctive drug-like molecules. These molecules were then analyzed for physicochemical properties using OpenBabel descriptors and clustered using various methods such as hierarchical clustering, binning partition and multidimensional scaling. EpiDBase provides comprehensive resources for further design, development and refinement of small molecule modulators of epigenetic markers.

The interactive effect of SIRT1 promoter region polymorphism on type 2 diabetes susceptibility in the North Indian population.

Our previous studies have implicated genes mainly involved in the activity of pancreatic ß cells in type 2 diabetes (T2D) susceptibility in the North Indian population. Recent literature on the role of SIRT1 as a potential master switch modulating insulin secretion and regulating gene expression in pancreatic ß cells has warranted an evaluation of SIRT1 promoter region polymorphisms in the North Indian population, which is the main focus of the present study. 1542 samples (692 T2D patients and 850 controls) were sequenced for the 1.46 kb region upstream the translation start site of the SIRT1 gene. We performed a functional characterization of the SIRT1 promoter region polymorphisms using luciferase assay and observed a single-nucleotide polymorphism (SNP), rs12778366, in association with SIRT1 expression. We propose that TT, the high-expressing genotype of SNP rs12778366 in the SIRT1 promoter region and present in >80% of the North Indian population, was favored under conditions of feast-famine cycles in evolution, which has turned out to be a cause of concern in the present sedentary lifestyle under ad libitum conditions. Case-control association analysis did not implicate rs12778366 in T2DM per se in the studied population. However, our earlier reported risk genotype combinations of mt-ND3, PGC1α, and UCP2-866, when compared with the protective genotype combinations, in the background of the high-expressing TT genotype of SIRT1 SNP rs12778366, showed a very high additive risk [corrected odd ratio (OR) = 8.91; p = 6.5×10(-11)]. The risk level was considerably low in the genotype backgrounds of TX (OR = 6.68; p = 2.71×10(-12)) and CX (OR = 3.74; p = 4.0×10(-3)). In addition, we screened other reported T2D-associated polymorphisms: PIK3R1 rs3730089, IRS1 rs1801278, and PPP1R3 rs1799999, which did not show any significant association in North Indian population. The present paper emphasizes the importance of gene interactions in the biological pathways of T2D, a complex lifestyle disease.

Spectrum of congenital surgical malformations in newborns.

A prospective study to detect the frequency and distribution of congenital surgical malformations in a rural hospital setting in Maharashtra was carried out. A total of 3000 consecutive births over a 9-month period was included and the frequency of congenital malformations was 21.1 per 1000 births. Stillbirths were associated with a higher incidence of malformations (14.5%) as compared to live births (1.8%). The commonest systems affected were the gastro-intestinal tract and the genito-urinary tract (20.4% each) followed by the central nervous system (17.3%). Among the various possible risk factors studied, a higher incidence of congenital malformations was associated with increasing maternal age (> 35 years), higher gravida mothers (> G4), parental consanguineous marriages, previous history of abortions, maternal hypertension, etc.