Local auxin biosynthesis promotes shoot patterning and stem cell differentiation in Arabidopsis shoot apex.

The shoot apical meristem (SAM) of higher plants comprises distinct functional zones. The central zone (CZ) is located at the meristem summit and harbors pluripotent stem cells. Stem cells undergo cell division within the CZ and give rise to descendants, which enter the peripheral zone (PZ) and become recruited into lateral organs. Stem cell daughters that are pushed underneath the CZ form rib meristem (RM). To unravel the mechanism of meristem development, it is essential to know how stem cells adopt distinct cell fates in the SAM. Here, we show that meristem patterning and floral organ primordia formation, besides auxin transport, are regulated by auxin biosynthesis mediated by two closely related genes of the TRYPTOPHAN AMINOTRANSFERASE family. In Arabidopsis SAM, TAA1 and TAR2 played a role in maintaining auxin responses and the identity of PZ cell types. In the absence of auxin biosynthesis and transport, the expression pattern of the marker genes linked to the patterning of the SAM is perturbed. Our results prove that local auxin biosynthesis, in concert with transport, controls the patterning of the SAM into the CZ, PZ and RM.

A methodical exploration of imaging modalities from dataset to detection through machine learning paradigms in prominent lung disease diagnosis: a review.

BACKGROUND: Lung diseases, both infectious and non-infectious, are the most prevalent cause of mortality overall in the world. Medical research has identified pneumonia, lung cancer, and Corona Virus Disease 2019 (COVID-19) as prominent lung diseases prioritized over others. Imaging modalities, including X-rays, computer tomography (CT) scans, magnetic resonance imaging (MRIs), positron emission tomography (PET) scans, and others, are primarily employed in medical assessments because they provide computed data that can be utilized as input datasets for computer-assisted diagnostic systems. Imaging datasets are used to develop and evaluate machine learning (ML) methods to analyze and predict prominent lung diseases. OBJECTIVE: This review analyzes ML paradigms, imaging modalities' utilization, and recent developments for prominent lung diseases. Furthermore, the research also explores various datasets available publically that are being used for prominent lung diseases. METHODS: The well-known databases of academic studies that have been subjected to peer review, namely ScienceDirect, arXiv, IEEE Xplore, MDPI, and many more, were used for the search of relevant articles. Applied keywords and combinations used to search procedures with primary considerations for review, such as pneumonia, lung cancer, COVID-19, various imaging modalities, ML, convolutional neural networks (CNNs), transfer learning, and ensemble learning. RESULTS: This research finding indicates that X-ray datasets are preferred for detecting pneumonia, while CT scan datasets are predominantly favored for detecting lung cancer. Furthermore, in COVID-19 detection, X-ray datasets are prioritized over CT scan datasets. The analysis reveals that X-rays and CT scans have surpassed all other imaging techniques. It has been observed that using CNNs yields a high degree of accuracy and practicability in identifying prominent lung diseases. Transfer learning and ensemble learning are complementary techniques to CNNs to facilitate analysis. Furthermore, accuracy is the most favored metric for assessment.

A computer vision-based system for real-time component identification from waste printed circuit boards.

With an exponential increase in consumers' need for electronic products, the world is facing an ever-increasing economic and environmental threat of electronic waste (e-waste). To minimize their adverse effects, e-waste recycling is one of the pivotal factors that can help in minimizing the environmental pollution andto increase recovery of valuable materials. For instance, Printed Circuit Boards (PCBs), while they have several valuable elements, they are hazardous too; and therefore, they form a large chunk of e-waste being generated today. Thus, in recycling PCBs, Electronic Components (ECs) are segregated at first, and separately processed for recovering key elements that could be re-used. However, in the current recycling process, especially in developing nations, humans manually screen ECs, which goes on to affect their health. It also causes losses of valuable materials. Therefore, automated solutions need to be adopted for both to classify and to segregate ECs from waste PCBs. The study proposes a robust EC identification system based on computer vision and deep learning algorithms (YOLOv3) to automate sorting process which would help in further processing. The study uses a publicly available dataset, and a PCB dataset which reflect challenging recycling environments like lighting conditions, cast shadows, orientations, viewpoints, and different cameras/resolutions. The outcome of YOLOv3 detection model based on training of both datasets presents satisfactory classification accuracy and capability of real-time competent identification, which in turn, could help in automatically segregating ECs, while leading towards effective e-waste recycling.

Understanding consumer preferences to develop dahi using pineapple pomace powder and monk-fruit extract.

Consumer preferences refer to the subjective assessments of products and services expressed by individuals. The objective of this investigation aims to examine the preferences of consumers regarding dahi, followed by the development of a corresponding product. The initial phase of the experimental design involves understanding the interests of consumers and the variables that influence their purchasing intentions through the administration of a questionnaire. The subsequent phase entails the development of dahi in accordance with consumer preferences, followed by an assessment of its nutritional value, sensory acceptability, and storage study. Subsequently, a significant proportion of consumers (91%) expressed an interest for the introduction of a pineapple-flavour (61.5%) spoon-able dahi (77%) containing natural sugar (65%) and packaged in a cup (71.5%) within the market. To adjust the sweetness intensity of monk fruit, a series of preliminary experiments were carried out to regulate the concentration to a level that can be considered sensory acceptable, specifically 05 g/100 ml. Afterwards, dahi was prepared by altering the concentration of FPP (freeze-dried pine-apple pomace powder) within the range of 0.5 to 2.5 g/100 ml. Prepared dahi were further subjected to sensory evaluation and storage study. Based on the obtained results and sensory analyst feedback, we conclude that the dahi formulation TPM2 exhibits considerable organoleptic acceptance and also has the potential for industrial-scale production to cater wider consumer demands. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05919-5.

AFP-SPTS: An Accurate Prediction of Antifreeze Proteins Using Sequential and Pseudo-Tri-Slicing Evolutionary Features with an Extremely Randomized Tree.

The development of intracellular ice in the bodies of cold-blooded living organisms may cause them to die. These species yield antifreeze proteins (AFPs) to live in subzero temperature environments. Additionally, AFPs are implemented in biotechnological, industrial, agricultural, and medical fields. Machine learning-based predictors were presented for AFP identification. However, more accurate predictors are still highly desirable for boosting the AFP prediction. This work presents a novel approach, named AFP-SPTS, for the correct prediction of AFPs. We explored the discriminative features with four schemes, namely, dipeptide deviation from the expected mean (DDE), reduced amino acid alphabet (RAAA), grouped dipeptide composition (GDPC), and a novel representative method, called pseudo-position-specific scoring matrix tri-slicing (PseTS-PSSM). Considering the advantages of ensemble learning strategy, we fused each feature vector into different combinations and trained the models with five machine learning algorithms, i.e., multilayer perceptron (MLP), extremely randomized tree (ERT), decision tree (DT), random forest (RF), and AdaBoost. Among all models, PseTS-PSSM + RAAA with an extremely randomized tree attained the best outcomes. The proposed predictor (AFP-SPTS) boosted the accuracies of AFPs in the literature by 1.82 and 4.1%.

Identification of potential Akt activators: a ligand and structure-based computational approach.

The Akt pathway plays a significant role in various diseases like Alzheimer's, Parkinson's, and Diabetes. Akt is the central protein whose phosphorylation controls many downstream pathways. Binding of small molecules to the PH domain of Akt facilitates its phosphorylation in the cytoplasm and upregulates the Akt pathway. In the current study, to identify Akt activators, ligand-based approaches like 2D QSAR, shape, and pharmacophore-based screening were used, followed by structure-based approaches such as docking, MM-GBSA, ADME prediction, and MD simulation. The top twenty-five molecules from the Asinex gold platinum database found to be active in most 2D QSAR models were used for shape and pharmacophore-based screening. Later docking was performed using the PH domain of Akt1 (PDB: 1UNQ), and 197105, 261126, 253878, 256085, and 123435 were selected based on docking score and interaction with key residues, which were druggable and formed a stable protein-ligand complex. MD simulations of 261126 and 123435 showed better stability and interactions with key residues. To further investigate the SAR of 261126 and 123435, derivatives were downloaded from PubChem, and structure-based approaches were employed. MD simulation of derivatives 12289533, 12785801, 83824832, 102479045, and 6972939 was performed, in which 83824832 and 12289533 showed interaction with key residues for a longer duration of time, proving that they may act as Akt activators.

Crystallographic, morphological and photoluminescent investigations of Tb3+ -doped YAlO3 perovskites for lighting applications.

Terbium(III)-doped yttrium aluminate perovskite (YAP:xTb3+ ) (x = 0.01-0.08 mol) was synthesized using a simple gel-combustion method. Structural elucidations were performed using X-ray diffraction (XRD) and Rietveld analysis. Fourier-transform infrared spectral studies validated the efficient synthesis of designed doped samples. Transmission electron microscopic images showed the agglomerated irregular dimensions of the synthesized nanocrystalline materials. When excited at 251 nm, a strong emissive line attributed to 5 D4 → 7 F5 electronic transition was observed at 545 nm (green emission). The maximum luminescence was found at the optimized concentration (0.05 mol) of Tb3+ ions; this emission was quenched by dipolar-dipolar (d-d) interactions. Chromaticity (x and y) and correlated colour temperature parameters were obtained by analysing the emission profiles. Finally, the colour coordinates of nanophosphors were closer to the National Television Standards Committee green coordinates, which replicates their potency in the design and architecture of R-G-B-based white LEDs.

Tryptamine: A privileged scaffold for the management of Alzheimer's disease.

Alzheimer's disease (AD) is a chronic and irreversible neurodegenerative disease associated with aging. It is characterized by the progressive loss of memory and other cognitive functions. Although the exact etiology of AD is not well explored, several factors, such as the deposition of amyloid-ß (Aß) plaques, hyperphosphorylation of tau protein, presence of low levels of acetylcholine, and generation of oxidative stress, are key mediators in the progression of AD. Currently, the clinical treatment options for AD are limited and are based on cholinesterase (ChE) inhibitors (e.g., donepezil, rivastigmine, and galantamine), N-methyl- d-aspartic acid receptor antagonists (e.g., memantine), and the recently approved Aß modulator (e.g., aducanumab). Tryptamine (2-(1H-indol-3-yl)ethan-1-amine) is a small molecule that contains an indole nucleus and an ethylamine side chain. It is also the active metabolite of tryptophan. It possesses a wide range of biological activities related to neurodegenerative disorders, such as ChE inhibition, Aß aggregation inhibition, antioxidant effects, monoamine-oxidase inhibition, and neuroprotection. Several tryptamine-based hybrid analogs are currently being investigated as multifunctional agents for the development of novel hybrids for AD treatment. Thus, this review article aims to provide in-depth insights into the research progress and strategies for designing multifunctional agents used in Alzheimer's therapy.

Discovery of Pyrimidine- and Coumarin-Linked Hybrid Molecules as Inducers of JNK Phosphorylation through ROS Generation in Breast Cancer Cells.

Human epidermal growth factor receptor 2 (HER2)-positive breast cancer exhibits early relapses, poor prognoses, and high recurrence rates. Herein, a JNK-targeting compound has been developed that may be of utility in HER2-positive mammary carcinoma. The design of a pyrimidine-and coumarin-linked structure targeting JNK was explored and the lead structure PC-12 [4-(3-((2-((4-chlorobenzyl)thio) pyrimidin-4-yl)oxy)propoxy)-6-fluoro-2H-chromen-2-one (5d)] was observed to selectively inhibit the proliferation of HER2-positive BC cells. The compound PC-12 exerted DNA damage and induced apoptosis in HER-2 positive BC cells more significantly compared to HER-2 negative BC cells. PC-12 induced PARP cleavage and down-regulated the expression of IAP-1, BCL-2, SURVIVIN, and CYCLIN D1 in BC cells. In silico and theoretical calculations showed that PC-12 could interact with JNK, and in vitro studies demonstrated that it enhanced JNK phosphorylation through ROS generation. Overall, these findings will assist the discovery of new compounds targeting JNK for use in HER2-positive BC cells.

Development of a Systematic Strategy toward Promotion of α-Synuclein Aggregation Using 2-Hydroxyisophthalamide-Based Systems.

Establishing a potent scheme against α-synuclein aggregation involved in Parkinson's disease has been evaluated as a promising route to identify compounds that either inhibit or promote the aggregation process of α-synuclein. In the last two decades, this perspective has guided a dramatic increase in the efforts, focused on developing potent drugs either for retardation or promotion of the self-assembly process of α-synuclein. To address this issue, using a chemical kinetics platform, we developed a strategy that enabled a progressively detailed analysis of the molecular events leading to protein aggregation at the microscopic level in the presence of a recently synthesized 2-hydroxyisophthalamide class of small organic molecules based on their binding affinity. Furthermore, qualitatively, we have developed a strategy of disintegration of α-synuclein fibrils in the presence of these organic molecules. Finally, we have shown that these organic molecules effectively suppress the toxicity of α-synuclein oligomers in neuron cells.

Pregnane-Oximino-Alkyl-Amino-Ether Compound as a Novel Class of TGR5 Receptor Agonist Exhibiting Antidiabetic and Anti-Dyslipidemic Activities.

INTRODUCTION: The present study deals with the synthesis of pregnane-oximino-amino-alkyl-ethers and their evaluation for antidiabetic and anti-dyslipidemic activities in validated animal and cell culture models. METHODS: The effect on glucose tolerance was measured in sucrose-loaded rats; antidiabetic activity was evaluated in streptozotocin (STZ)-induced diabetic rats and genetically diabetic db/db mice; the anti-dyslipidemic effect was characterized in high-fructose, high-fat diet (HFD)-fed dyslipidemic hamsters. The effect on glucose production and glucose utilization was analyzed in HepG2 liver and L6 skeletal muscle cells, respectively. RESULTS: From the synthesized molecules, pregnane-oximino-amino-alkyl-ether (compound 14b) improved glucose clearance in sucrose-loaded rats and exerted antihyperglycemic activity on STZ-induced diabetic rats. Further evaluation in genetically diabetic db/db mice showed temporal decrease in blood glucose, and improvement in glucose tolerance and lipid parameters, associated with mild improvement in the serum insulin level. Moreover, compound 14b treatment displayed an anti-dyslipidemic effect characterized by significant improvement in altered lipid parameters of the high-fructose, HFD-fed dyslipidemic hamster model. In vitro analysis in the cellular system suggested that compound 14b decreased glucose production in liver cells and stimulated glucose utilization in skeletal muscle cells. These beneficial effects of compound 14b were associated with the activation of the G-protein-coupled bile acid receptor TGR5. CONCLUSION: Compound 14b exhibits antidiabetic and anti-dyslipidemic activities through activating the TGR5 receptor system and can be developed as a lead for the management of type II diabetes and related metabolic complications.

Proficient exclusion of pesticide using humic acid-modified magnetite nanoparticles from aqueous solution.

Extensive dispersal of the pesticides to shield the different types of vegetation from pests has increased the production but at the same it has resulted in an increase in environmental pollution. Consequently, it is necessary to eliminate these undesired pollutants from the environment. The current investigation offers the synthesis of humic acid-coated magnetite nanoparticles towards effective removal of the most common insecticide, imidacloprid, from aqueous solution using a batch adsorption method. These synthesized nanoparticles were characterized with the help of several analytical and spectroscopic techniques. To acquire the maximum conceivable adsorption, effects of different influencing parameters like pH of the solution, time of contact, concentration of pesticide solution, amount of adsorbent and temperature were also examined. Moreover, the kinetic studies were found to be in good agreement with a pseudo-second-order kinetic model supporting the occurrence of chemisorption phenomenon. Additionally, isotherm modeling proved that the adsorption process was in accordance with the Langmuir model of isotherm. Thermodynamic parameters depicted the endothermic and spontaneous behavior of the adsorption process. Desorption studies were also carried out to examine the reusability of these nano-adsorbents. These verdicts confirmed that the surface modified magnetite nanoparticles may be treated as proficient material for exclusion of imidacloprid from the aqueous solution.

Evaluation of Probiotic Effects of Lactobacilli on Mutans Streptococci: An In Vitro Study.

AIM: The aim of the present study is to evaluate the probiotic effect of Lactobacillus acidophilus and Lactobacillus rhamnosus on clinical isolates of Mutans Streptococci (MS) and antibiotic susceptibility of these strains to commonly used antibiotics in dentistry. MATERIALS AND METHODS: Plaque samples from permanent first molars were collected and transferred aseptically onto Mitis-Salivarius agar and incubated at 37°C for 24 hours in the presence of 5-10% CO2. Mutans streptococci colonies were identified biochemically using Hi-Strep identification kit. The inhibitory activity of the clinical strains of MS on Lactobacilli was investigated using agar-overlay interference technique. Positive inhibition was appreciated as a clear zone around the Lactobacilli. Disk diffusion assay was done as described by CLSI M100-S25 for antibiotic susceptibility. The zone of growth inhibition caused by Lactobacilli and antibiotics on MS clinical strains was measured directly using a vernier caliper. Statistical analysis was done using independent t-test. RESULTS: Mutans streptococci exhibited positive inhibition with both the probiotic strains and L. acidophilus showed more zones of inhibition than L. rhamnosus. Antibiotic susceptibility of clinical strains of MS showed sensitivity to penicillin and vancomycin, however, tetracycline and erythromycin showed very few resistant strains. The highest zone of inhibition was shown by cephalothin followed by penicillin, tetracycline, ciprofloxacin, erythromycin, and vancomycin. CONCLUSION: L. rhamnosus and L. acidophilus have strong inhibitory effects on clinical strains of MS. Lactobacillus acidophilus showed a higher zone of inhibition. All the clinical strains of MS were sensitive to penicillin and vancomycin. The highest zone of inhibition was shown by cephalothin. CLINICAL SIGNIFICANCE: Dental caries remains silent epidemic and increasing antibiotic resistance is another major challenge that threatens the world. Newer methods such as whole-bacteria replacement therapy using probiotics for decreasing harmful oral pathogens and reducing the intake of antibiotics must be explored. More researches to promote use of probiotics should be initiated due to its possible preventive and health maintenance benefits providing an end to new cavities and antibiotic resistance.

Manufacturing and characterization of whey and stevia-based popsicles enriched with concentrated beetroot juice.

The beet-root (Beta vulgaris) and whey powder together, can potentially use as a multifunctional ingredient in the manufacturing of the "Popsicles", due to their biochemical composition that can enhance the concentration of bioactive compounds. In the present study, beet-root juice concentrates were prepared at different time/temperature treatments viz 45 °C, 55 °C, and 65 °C for 120, 80 and 45 min. The effect of different time/temperature treatments on physicochemical composition, colour, antioxidant activity (%), bioactive compounds, spectral data and sensory acceptance were evaluated. The physicochemical parameters of popsicles (PTI, PT2, PT3) including protein, total phenols, betalain, radical scavenging activity %, colour and melting values were significantly affected (p ≤ 0.05) by the different time/temperature treatments. The concentration of betalain and protein in all the popsicles ranged from 1134 to 1299 mg/L and 1.92 to 1.54 g/100 g respectively. The reduction of bioactive components viz betacyanins, betaxanthins, betanin, oxalic and syringic acid was also observed in popsicle (PTI) as compared to control. Furthermore, popsicle (PT1) was prepared with beet-root juice concentrated at 45 °C showed maximum sensory acceptance. The physicochemical and organoleptic attributes of processed popsicles encourage the commercial usage of whey powder and concentrated beetroot juice.

Health related quality of life in pediatric onset Type 1 diabetes mellitus in Kerala, India.

BACKGROUND: To study the health-related quality of life (HRQoL) in pediatric onset Type 1 diabetes mellitus (TIDM) in the state of Kerala in India. METHODS: Diabetes specific HRQoL was determined in 107 subjects with onset of T1DM less than 21 years using the Pediatric Quality of Life Inventory (PedsQL) 3.2 questionnaire of which 69 also completed the PedsQL 4.0 generic questionnaire. The parents of these patients completed the proxy scoring questionnaire. The generic HRQoL of T1DM was compared with control population without diabetes. RESULTS: Mean age of onset of T1DM was 8.2 ± 4.6 years and mean duration was 8.2 ± 5.6 years. The median HbA1c was 8.7% (72 mmol/mol). Microvascular complications were present in 14.9% of the patients. The generic HRQoL was lower in patients with T1DM compared to peers without diabetes (77.43 vs. 87.45; p < 0.001). Parents reported lower scores in diabetes management, treatment barriers, physical functioning and generic scales compared to patients. Parents reported greater worry about the disease with lesser age of onset of diabetes and with presence of complications. Those using insulin vials and on splitmix regimen had lower HRQoL compared to those using insulin pens. The patients belonging to lower socioeconomic status (SES) reported lower diabetes scores (73.7 vs. 58.7; p = 0.015). CONCLUSIONS: The generic HRQoL was lower in children with T1DM compared to peers without diabetes. Parents and children had different perception about HRQoL in many aspects. The diabetes specific scores were lower in those belonging to lower SES.

Monogenic diabetes: A single center experience from South India.

Monogenic forms of diabetes in children are frequently misclassified as either type 1 diabetes or young-onset type 2 diabetes. There is a paucity of literature regarding pediatric monogenic diabetes in the Indian population. A retrospective analysis of case records of 37 children with monogenic diabetes who were diagnosed between 2008 and 2019 in a South Indian tertiary care center was performed. The write-up describes the clinical, biochemical, and genetic characterization of these patients with the diagnoses of neonatal diabetes mellitus (15 patients), MODY (five patients), and various forms of syndromic diabetes (13 with Wolfram syndrome, two with H syndrome, one with mitochondrial diabetes, and one with thiamine responsive megaloblastic anemia).

Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV-19 corona virus vaccine (recombinant).

With the present COVID-19 vaccination drive across the world, adverse skin reactions post COVID-19 vaccine is expected. Majority of these reactions seen were transient or local injection site reactions. However, as the larger population is being vaccinated, certain uncommon dermatological presentations including leukocytoclastic vasculitis, pityriasis rosea, and exacerbation of pre-existing autoimmune diseases are now being reported. Among all the COVID-19 vaccines, most of these reactions are seen with messenger ribonucleic acid-based Pfizer/BioNTech (BNT162b2) and Moderna (mRNA-1273) vaccine. We report two cases of leukocytoclastic vasculitis following ChAdOx1 nCoV-19 corona virus vaccine (recombinant) that bring out potential new dermatological manifestations of recombinant corona virus vaccine being administered across the European, South American, and Asian countries. It is important for all health care workers and patients to be aware of the corona virus vaccine associated adverse cutaneous reactions.

Assessment of feasibility and acceptability of family-centered care implemented at a neonatal intensive care unit in India.

BACKGROUND: A family-centered care (FCC) parent participation program that ensures an infant is not separated from parents against their will was developed for the caring of their small or sick newborn at a neonatal intensive care unit (NICU) in Delhi, India. Healthcare provider sensitization training directed at psychosocial and tangible support and an audio-visual training tool for parent-attendants were developed that included: 1) handwashing, infection prevention, protocol for entry; 2) developmentally supportive care, breastfeeding, expression of breastmilk and assisted feeding; 3) kangaroo mother care; and 4) preparation for discharge and care at home. The study aimed to examine the feasibility and acceptability of the FCC model in a NICU in India. METHODS: A prospective cohort design collected quantitative data on each parent-attendant/infant dyad at enrollment, during the NICU stay, and at discharge. Feasibility of the FCC program was measured by assessing the participation of parent-attendants and healthcare providers, and whether training components were implemented as intended. Acceptability was measured by the proportion of parent-attendants who participated in the trainings and their ability to accurately complete program activities. RESULTS: Of 395 NICU admissions during the study period, eligible participants included 333 parent-attendant/infant dyads, 24 doctors, and 21 nurses. Of the 1242 planned parent-attendant training sessions, 939 (75.6%) were held, indicating that program fidelity was high, and the majority of trainings were implemented as intended. While 50% of parent-attendants completed all 4 FCC training sessions, 95% completed sessions 1 and 2; 60% of the total participating parent-attendants completed session 3, and 75% completed session 4. Compliance rates were over 96% for 5 of 10 FCC parent-attendant activities, and 60 to 78% for the remaining 5 activities. CONCLUSIONS: FCC was feasible to implement in this setting and was acceptable to participating parent-attendants and healthcare providers. Parents participated in trainings conducted by NICU providers and engaged in essential care to their infants in the NICU. A standard care approach and behavior norms for healthcare providers directed psychosocial and tangible support to parent-attendants so that a child is not separated from his or her parents against their will while receiving advanced care in the NICU.

Putting the local back into planning-experiences and perceptions of state and district health functionaries of seven aspirational districts in India on an innovative planning capacity building approach.

District functionaries have ostensibly a major responsibility to develop evidence based plans. However, this responsibility is not commensurate with skills and expertise among functionaries in many Indian states. Vriddhi project-technical partner of the government, developed a planning tool for maternal and neonatal health programmes, called RMNCH + A Action Agenda using Strategic Approach (RAASTA), which was introduced in a workshop format in two states and attended by program officers. Qualitative feedback was obtained from selected participants to understand their experience of the workshop and of the planning tool. It emerged that previous planning process had little application of local evidence based solutions. Participants appreciated the alternative approach as RAASTA equipped them to use local evidence. Several action plans derived at the workshop were included in the state plan. At the same time, apprehension was expressed by participants about translating their learnings to practical application as planning was not a central priority in their scheme of duties and tasks. Enhanced support from states in refreshing district planners' skills would be an important step. One state government has scaled up the RAASTA tool while an electronic version is being developed for future use as it demonstrates great potential to equip and aid district officials in developing evidence based plans.

Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis.

Following the demonstration of the efficacy of hydroxychloroquine against severe acute respiratory syndrome coronavirus 2 in vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta-analysis have addressed the issue of the safety and efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019. We conducted a systematic review and meta-analysis with the objectives of evaluation of safety and efficacy of HCQ alone or in combination in terms of "time to clinical cure," "virological cure," "death or clinical worsening of disease," "radiological progression," and safety. RevMan was used for meta-analysis. We searched 16 literature databases out of which seven studies (n = 1358) were included in the systematic review. In terms of clinical cure, two studies reported possible benefit in "time to body temperature normalization" and one study reported less "cough days" in the HCQ arm. Treatment with HCQ resulted in less number of cases showing the radiological progression of lung disease (odds ratio [OR], 0.31, 95% confidence interval [CI], 0.11-0.9). No difference was observed in virological cure (OR, 2.37, 95% CI, 0.13-44.53), death or clinical worsening of disease (OR, 1.37, 95% CI, 1.37-21.97), and safety (OR, 2.19, 95% CI, 0.59-8.18), when compared with the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + azithromycin. Although seems safe and effective, more data are required for a definitive conclusion. HCQ seems to be promising in terms of less number of cases with radiological progression with a comparable safety profile to control/conventional treatment. We need more data to come to a definite conclusion.