Assessment of Knowledge on Palliative Care among the Community Health Officers in Rural Area of Purba Medinipur District, West Bengal, India.

Objectives: Palliative care deals with patients who are facing problems of life-threatening diseases. Under the Ayushman Bharat programme, a new cadre of Community Health Officers (CHOs) is provisioned at Health and Wellness Centres (HWCs) who are nursing graduates. Being the team leader at the HWC level, having a low level of knowledge of palliative care would compromise their service. The study assessed the knowledge of CHOs about palliative care services in a rural district of Purba Medinipur, West Bengal, India. Materials and Methods: A descriptive study with a cross-sectional design was carried out among 314 CHOs posted in different HWCs of Purba Medinipur, West Bengal, during July-August' 2022. We used to collect data based on questionnaires of 'Palliative-Care-Knowledge Questionnaire-Basic' comprising items related to palliative care, the requirement of palliative care, pain management, communication, and dealing with psychosocial issues. A chi-square test was performed to check the association with educational- and experience-related variables and knowledge. Results: Overall, adequate knowledge was present in 216 (68.8%) and inadequate knowledge in 98 (31.2%) of CHOs. Improper knowledge was present regarding the role of oxygen supplementation in dying patients, the need for palliative care in human immunodeficiency virus/acquired immunodeficiency syndrome, chronic non-malignant diseases, pain management, and communication about the prognosis of disease. The proportion of CHOs who had adequate knowledge who were highly educated (70%) and those who had previous job as CHO (73.3%). Almost similar knowledge scores were found among those who ever cared for or never cared for either terminally ill patients (P = 0.89) or cancer patients (P = 0.853). Conclusion: In-depth knowledge was lacking among the CHOs. Training and re-training of CHOs to develop technical and communication skills will help them deliver proper palliative care.

Comparison of the Identification of Emotional Facial Expressions from Full Faces with only the Eyes and the Mouth Regions in Young Indian Adults: an Exploratory Study.

Background: Identification of emotional facial expressions (EFEs) is important in interpersonal communication. Six 'universal' EFEs are known, though accuracy of their identification varies. EFEs involve anatomical changes in certain regions of the face, especially eyes and mouth. But whether other areas of the face are just as important in their identification is still debated. This study was conducted to compare the accuracy of identification of universal EFEs under full-face and partial face conditions (only showing the eyes and the mouth regions). Methods: An analytical cross-sectional study was conducted among 140 young Indian adults. They were divided into two equal groups and shown the six universal EFEs in two sets, one with full-face images, and the other with images showing just the eyes and the mouth regions on a computer screen. The participants were asked to identify each of the EFE and their responses were analyzed. Results: Mean age was 21.3 1.7 years for full face group, and 21.2 1.6 years for the partial face group. Most were men, from rural areas and from upper socioeconomic status families, and many of them were students. EFE identification was significantly higher for part-face group compared to full-face group (p-value .0007). Participants of both groups identified happiness the best (100%). For other EFEs, part-face images were identified more accurately than full-face images, except for disgust. These differences were statistically significant except for anger and fear. Conclusions: Among young Indian adults, accuracy of identification of universal EFEs was high, which was significantly enhanced for all except disgust, when only combinations of eyes and mouth were shown, suggesting that other facial regions serve as distractors in EFE identification. Key Messages: 1. Identification of universal EFEs was higher from partial faces (combination of eyes and mouth) as compared to full-face EFEs for all emotions except disgust. 2. This suggests that other regions of face serve as potential distractors in the identification of emotions, except for disgust, where these regions provide more information.

Antecedentes: La identificación de las expresiones faciales emocionales (EFEs) es importante en la comunicación interpersonal. Se conocen seis EFEs "universales", aunque la precisión de su identificación varía. Los EFEs involucran cambios anatómicos en ciertas regiones del rostro, especialmente los ojos y la boca. Sin embargo, todavía se debate si la identificación de las otras áreas del rostro es igualmente importante. Este estudio se llevó a cabo para comparar la precisión de la identificación de los EFEs universales en condiciones de rostro completo y rostro parcial, mostrando solo las regiones de los ojos y la boca. Método: Se llevó a cabo un estudio analítico transversal entre 140 adultos jóvenes indios. Fueron divididos en dos grupos iguales y se les mostraron los seis EFEs universales en dos conjuntos, uno con imágenes de rostro completo y otro con imágenes que mostraban solo las regiones de los ojos y la boca. A los participantes se les pidió que identificaran cada uno de los EFE y sus respuestas fueron analizadas. Resultados: La edad promedio fue de 21.3 1.7 años para el grupo de rostro completo y de 21.2 1.6 años para el grupo de rostro parcial. La mayoría de los participantes eran hombres, provenían de áreas rurales, pertenecían a familias de nivel socioeconómico alto y eran estudiantes. La identificación de EFEs fue significativamente mayor en el grupo de rostro parcial en comparación con el grupo de rostro completo (p = .0007). Los participantes de ambos grupos identificaron mejor la felicidad (100%). Para los demás EFEs, las imágenes de rostro parcial se identificaron con mayor precisión que las imágenes de rostro completo, excepto en el caso del asco. Estas diferencias fueron estadísticamente significativas, excepto en los casos de ira y miedo. Conclusiones: Entre los adultos jóvenes indios, la precisión en la identificación de EFEs universales fue alta, lo cual se mejoró significativamente para todos, excepto el asco, cuando solo se mostraron combinaciones de ojos y boca. Esto sugiere que otras regiones faciales actúan como distractores en la identificación de EFEs.

Chronic Exposure to Drinking Water Arsenic and Gallbladder Cancer Risk: Preliminary Evidence from Endemic Regions of India.

BACKGROUND: Evidence linking arsenic in drinking water to digestive tract cancers is limited. We evaluated the association between arsenic levels in groundwater and gallbladder cancer risk in a case-control study (2019-2021) of long-term residents (≥10years) in two arsenic-impacted and high gallbladder cancer risk states of India-Assam and Bihar. METHODS: We recruited men and women aged 30 to 69 years from hospitals (73.4% women), with newly diagnosed, biopsy-confirmed gallbladder cancer (N = 214) and unrelated controls frequency-matched for 5-year age, sex, and state (N = 166). Long-term residential history, lifestyle factors, family history, socio-demographics, and physical measurements were collected. Average-weighted arsenic concentration (AwAC) was extrapolated from district-level groundwater monitoring data (2017-2018) and residential history. We evaluated gallbladder cancer risk for tertiles of AwAC (µg/L) in multivariable logistic regression models adjusted for important confounders [Range: 0-448.39; median (interquartile range), T1-0.45 (0.0-1.19); T2-3.75 (2.83-7.38); T3-17.6 (12.34-20.54)]. RESULTS: We observed a dose-response increase in gallbladder cancer risk based on AwAC tertiles [OR = 2.00 (95% confidence interval, 1.05-3.79) and 2.43 (1.30-4.54); Ptrend = 0.007]. Participants in the highest AwAC tertile consumed more tubewell water (67.7% vs. 27.9%) and reported more sediments (37.9% vs. 18.7%) with unsatisfactory color, odor, and taste (49.2% vs. 25.0%) than those in the lowest tertile. CONCLUSIONS: These findings suggest chronic arsenic exposure in drinking water at low-moderate levels may be a potential risk factor for gallbladder cancer. IMPACT: Risk factors for gallbladder cancer, a lethal digestive tract cancer, are not fully understood. Data from arsenic-endemic regions of India, with a high incidence of gallbladder cancer, may offer unique insights. Tackling 'arsenic pollution' may help reduce the burden of several health outcomes.

Prevalence of Risk Factors of Non-communicable Diseases among Adolescents of a Rural Area in Darjeeling District of West Bengal.

INTRODUCTION: Adolescence is the transitional period between childhood and adulthood when new health behaviors are laid down, which may track in to adulthood and have lifelong impact. Global trends show that these NCD-related behaviors are gradually rising among young people, and that they establish patterns of behavior that persist throughout life and are often hard to alter. OBJECTIVE: To find out the prevalence and socio demographic predictors of risk factors of non communicable diseases among adolescents of a rural area Methods: A community based cross sectional study was conducted among 365 adolescents residing in a rural area of Siliguri subdivision. They were interviewed and measurements were taken using standard procedure. RESULTS: The prevalence of behavioural factors for NCDs like tobacco use, alcohol use, unhealthy diet, physically inactivity was 18.4%, 4.7%, 87.1% and 23.0% respectively; metabolic risk factors like overweight, hypertension, and abdominal obesity 28.5%, 17.5%, 1.4% respectively. After adjustment, the odds of behavioural and metabolic risk factors were found highest among the males, participants whose mothers were not working and those who belonged to Hindu families and lower socioeconomic class. CONCLUSION: The proportion of risk factors of non communicable diseases among the rural adolescents was quite high'. Given the associated health problems and costs, non communicable diseases have become an issue of serious concern.

Seven potential sources of arsenic pollution in Latin America and their environmental and health impacts.

This review presents a holistic overview of the occurrence, mobilization, and pathways of arsenic (As) from predominantly geogenic sources into different near-surface environmental compartments, together with the respective reported or potential impacts on human health in Latin America. The main sources and pathways of As pollution in this region include: (i) volcanism and geothermalism: (a) volcanic rocks, fluids (e.g., gases) and ash, including large-scale transport of the latter through different mechanisms, (b) geothermal fluids and their exploitation; (ii) natural lixiviation and accelerated mobilization from (mostly sulfidic) metal ore deposits by mining and related activities; (iii) coal deposits and their exploitation; (iv) hydrocarbon reservoirs and co-produced water during exploitation; (v) solute and sediment transport through rivers to the sea; (vi) atmospheric As (dust and aerosol); and (vii) As exposure through geophagy and involuntary ingestion. The two most important and well-recognized sources and mechanisms for As release into the Latin American population's environments are: (i) volcanism and geothermalism, and (ii) strongly accelerated As release from geogenic sources by mining and related activities. Several new analyses from As-endemic areas of Latin America emphasize that As-related mortality and morbidity continue to rise even after decadal efforts towards lowering As exposure. Several public health regulatory institutions have classified As and its compounds as carcinogenic chemicals, as As uptake can affect several organ systems, viz. dermal, gastrointestinal, peptic, neurological, respiratory, reproductive, following exposure. Accordingly, ingesting large amounts of As can damage the stomach, kidneys, liver, heart, and nervous system; and, in severe cases, may cause death. Moreover, breathing air with high As levels can cause lung damage, shortness of breath, chest pain, and cough. Further, As compounds, being corrosive, can also cause skin lesions or damage eyes, and long-term exposure to As can lead to cancer development in several organs.

Remediation of carcinogenic arsenic by pyroaurite-based green adsorbent: isotherm, kinetic, mechanistic study, and applicability in real-life groundwater.

The removal of the harmful carcinogen arsenic from drinking water by a green technology is a major concern in the field of environmental engineering. The sorptive profile of arsenic remediation by calcined Mg-Fe-layered double hydroxide, fabricated by a one-pot synthesis technique, was investigated to delineate its applicability in real-life water. The physicochemical properties of adsorbent, as demonstrated from spectroscopy and microscopy, which described the existence of amorphous material with significant surface roughness possess selectivity towards arsenic. The isotherm and kinetic along with thermodynamic modeling exhibited the occurrence of spontaneous (ΔG0 value = - 8.084 kJ/mol to - 10.942 kJ/mol), endothermic (ΔH0 value = 12.135 kJ/mol), and physisorption reactions (Ead = 4.103-5.832 kJ/mol, Ea = 11.546 kJ/mol, S* = 0.0005 << 1, and ΔHx = 9.23-16.29 kJ/mol) with high uptake rate and adsorption potential of adsorbent. The isotherm and kinetics were demonstrated by Temkin (R2 = 0.944-0.969) and Elovich (R2 = 0.996-0.998) models, respectively, with high statistical significance. The intraparticle diffusion model which established the rate-limiting step is the combination of both film and pore diffusions. The applicability of layered double hydroxide (LDH) material in the real-life water was confirmed by isotherm and kinetic modeling along with the regeneration/reuse potential. The adsorptive removal of arsenic by the LDH material exhibited to be a promising technique without creating any secondary hazard.

Synthesis, characterization and unravelling the molecular interaction of new bioactive 4-hydroxycoumarin derivative with biopolymer: Insights from spectroscopic and theoretical aspect.

In the progress of small molecule as drug candidates, 4-hydroxycoumarin based compounds bearing a crucial place as potent antibiotic agents with appreciable safety in drug invention. Being synthetically and easily obtainable, 4-hydroxycoumarin related compounds with planar structure have been promoted predominantly as DNA targeting agent. Nevertheless, here we elucidate the synthesis, characterization and theoretical study of bio-active small molecule 4-hydroxy-3,4'-bichromenyl-2,2'-dione (4HBD). Then we have illuminated the binding interactions of 4HBD with calf thymus DNA (ctDNA), which is particularly designed for biological application. Extensive investigations of the binding of 4HBD with ctDNA are provided by utilizing multi-spectroscopic and molecular docking approaches, including UV-vis absorbance, steady-state, time-resolved fluorescence spectroscopy and circular dichroism study. The calculated binding and quenching constant value from quantitative data analysis of absorption and emission spectroscopy shows that 4HBD binds to the ctDNA groove. Further confirmation of the same is found by comparative displacement and iodide quenching studies. Negative enthalpy, negative free energy and positive entropy change imply a hydrophobic force monitors the association of 4HBD with the biomacromolecule. Interestingly the small molecule (4HBD) shows potential anti-bacterial activity against the model pathogenic gram-negative (Escherichia coli and Pseudomonas aeruginosa) and gram-positive (Bacillus subtilis and Staphylococcus aureus) bacteria. The noncytotoxic nature of the 4HBD is demonstrated in vitro with the help of MTT assay by normal kidney epithelial (NKE), breast cancer cells (MCF-7) and human prostate cancer cell (PC3) lines. Hemolytic assay exhibits insignificant hemolysis of human erythrocyte cells at the minimum inhibitory concentration (MIC) of these tested bacteria. In this regard the present invention of 4-hydroxycoumarin based antimicrobial and noncytotoxic 4HBD molecule holds future promise in the development of new antibiotics.