Enhancing translation of science into non-English languages.

Translating scientific findings from English to other native languages is essential to make sure that they can be integrated into timely and informed dialogue with policymakers and a diverse range of audiences who are affected by the science. Here, we present innovative approaches how to enhance access to scientific knowledge in non-English languages.

Improved subseasonal prediction of South Asian monsoon rainfall using data-driven forecasts of oscillatory modes.

Predicting the temporal and spatial patterns of South Asian monsoon rainfall within a season is of critical importance due to its impact on agriculture, water availability, and flooding. The monsoon intraseasonal oscillation (MISO) is a robust northward-propagating mode that determines the active and break phases of the monsoon and much of the regional distribution of rainfall. However, dynamical atmospheric forecast models predict this mode poorly. Data-driven methods for MISO prediction have shown more skill, but only predict the portion of the rainfall corresponding to MISO rather than the full rainfall signal. Here, we combine state-of-the-art ensemble precipitation forecasts from a high-resolution atmospheric model with data-driven forecasts of MISO. The ensemble members of the detailed atmospheric model are projected onto a lower-dimensional subspace corresponding to the MISO dynamics and are then weighted according to their distance from the data-driven MISO forecast in this subspace. We thereby achieve improvements in rainfall forecasts over India, as well as the broader monsoon region, at 10- to 30-d lead times, an interval that is generally considered to be a predictability gap. The temporal correlation of rainfall forecasts is improved by up to 0.28 in this time range. Our results demonstrate the potential of leveraging the predictability of intraseasonal oscillations to improve extended-range forecasts; more generally, they point toward a future of combining dynamical and data-driven forecasts for Earth system prediction.

Ischemia but no obstructive coronary artery disease: more than meets the eye.

Symptomatic women with angina are more likely to have ischemia with no obstructive coronary arteries (INOCA) compared to men. In both men and women, the finding of INOCA is not benign and is associated with adverse cardiovascular events, including myocardial infarction, heart failure and angina hospitalizations. Women with INOCA have more angina and a lower quality of life compared to men, but they are often falsely reassured because of a lack of obstructive coronary artery disease (CAD) and a perception of low risk. Coronary microvascular dysfunction (CMD) is a key pathophysiologic contributor to INOCA, and non-invasive imaging methods are used to detect impaired microvascular flow. Coronary vasospasm is another mechanism of INOCA, and can co-exist with CMD, but usually requires invasive coronary function testing (CFT) with provocation testing for a definitive diagnosis. In addition to traditional heart disease risk factors, inflammatory, hormonal and psychological risk factors that impact microvascular tone are implicated in INOCA. Treatment of risk factors and use of anti-atherosclerotic and anti-anginal medications offer benefit. Increasing awareness and early referral to specialized centers that focus on INOCA management can improve patient-oriented outcomes. However, large, randomized treatment trials to investigate the impact on major adverse cardiovascular events (MACE) are needed. In this focused review, we discuss the prevalence, pathophysiology, presentation, diagnosis and treatment of INOCA.

Short-term clinical and manometric outcomes of percutaneous tibial nerve stimulation for faecal incontinence: a large single-centre series.

BACKGROUND: Faecal incontinence (FI) is common, with a significant impact on quality of life. Percutaneous tibial nerve stimulation (PTNS) is a therapy for FI; however, its role has recently been questioned. Here we report the short-term clinical and manometric outcomes in a large tertiary centre. METHODS: A retrospective review of a prospective PTNS database was performed, extracting patient-reported FI outcome measures including bowel diary, the St Marks's Incontinence Score (SMIS) and Manchester Health Questionnaire (MHQ). Successful treatment was > 50% improvement in symptoms, whilst a partial response was 25-50% improvement. High-resolution anorectal manometry (HRAM) results before and after PTNS were recorded. RESULTS: Data were available from 135 patients [119 (88%) females; median age: 60 years (range: 27-82years)]. Overall, patients reported a reduction in urge FI (2.5-1) and passive FI episodes (2-1.5; p < 0.05) alongside a reduction in SMIS (16.5-14) and MHQ (517.5-460.0; p < 0.001). Some 76 (56%) patients reported success, whilst a further 20 (15%) reported a partial response. There were statistically significant reductions in rectal balloon thresholds and an increase in incremental squeeze pressure; however, these changes were independent of treatment success. CONCLUSION: Patients report PTNS improves FI symptoms in the short term. Despite this improvement, changes in HRAM parameters were independent of this success. HRAM may be unable to measure the clinical effect of PTNS, or there remains the possibility of a placebo effect. Further work is required to define the role of PTNS in the treatment of FI.

Evaluation of morphological traits using multivariate techniques in Kotdhar goat native to Shivalik hill region of Himachal Pradesh.

The objective of this study was to analyze the diverse morphological attributes of Kotdhar goat native to Shivalik hill region of Himachal Pradesh. A total number of 180 goats, comprising 150 females and 30 males aged between 1 and 3 years, were randomly selected to estimate15 distinct morphological traits and ten body indices. Mean values of 17.66 cm, 11.68 cm, 8.73 cm, 71.94 cm, 69.83 cm, 74.48 cm, 38.10 cm, 73.38 cm, 20.55 cm, 16.48 cm, 14.89 cm, 13.57 cm, 19.20 cm, 7.71 cm and 26.12 kg were estimated for head length, head width, face length, body length, wither height, heart girth, chest depth, rump height, rump length, rump width, haunch width, bicoastal width, shoulder width, cannon bone and body weight respectively. In addition, morphological indices viz. body index, length index, body ratio, thoracic development, pelvic index, longitudinal pelvic index, transverse pelvic index, proportionality index, dactyl thorax index and relative depth of thorax were estimated from morphological traits. Results of morphological indices indicated that Kotdhar goat are medium bodied, longilinear, tall animals and well-suited for meat production. Phenotypic correlation among most of traits was positive and significant. Among all correlations, correlation between head length and head width was found lowest (- 0.270), while the correlation between heart girth and chest depth was observed highest (0.861). Canonical discriminant function analysis showed that there was no considerable level of intermixing for morphological traits in Kotdhar goat. Employing principal component analysis with varimax rotation, three principal components were observed, accounting for 68.47% of the total variation. First principal component (PC1) encapsulated the highest proportion of variance (44.39), revealing the high loadings on head length (0.777), body length (0.747), wither height (0.782), heart girth (0.785), chest depth (0.706), rump height (0.762), haunch width (0.734) and bicoastal width (0.793). Hence, it is possible to utilize these eight variables out of the 15 morphological traits for the characterization of the Kotdhar goat.

Smoking blunts sertraline response in depression: A prospective observational cohort study.

Background: Smoking is common in patients of depression and is known to affect response to antidepressants. This study was undertaken to evaluate the effect of smoking on the antidepressant effect of sertraline. Method: Patients with depression were divided into smoker and nonsmoker cohorts and followed up for 8 weeks. Serum sertraline levels were estimated using the high-performance liquid chromatography system. Response to treatment was evaluated with the Hamilton Depression Rating Scale (HAM-D). Results: Serum sertraline levels did not differ between smokers and nonsmokers at 4 and 8 weeks. Nonsmokers responded better to sertraline than smokers after 8 weeks. Adverse drug reaction profile did not vary between the two groups and was not impacted by serum sertraline levels. Nonsmokers showed a greater fall in the HAM-D score than smokers. Conclusion: This study found depression among smokers to be less responsive to sertraline. This was not explained by serum sertraline levels. Treatment of depression in smokers with sertraline might require higher doses and duration, with more frequent reviews.

Microwave assisted disinfestation of green gram (Vigna radiata L.) infested with pulse beetle, Callasobruchus maculatus (F.).

Pulse beetle (Callasobruchus maculatus) is a common infestation during storage of legumes in India, and presently being managed by chemical fumigation. In the present investigation, a non-chemical method based on dielectric heating by microwaves (900 W, 2450 MHz) was studied for disinfestation of green gram at different grain layer thickness (5, 10, 15 and 20 mm) and exposure durations (0-60 s). The susceptibility (LT95) of different stages was in the order of egg (31.668 s) > grub (40.388 s) > pupa (44.176 s) > adult (49.018 s). The adult was tolerant up to 50 s (R2-0.799, P < 0.01) to microwave exposure duration without green gram, and up to 30 s (R2-0.804, P < 0.01) with green gram. Hundred percent mortality was observed at 10 mm (30 s, R2-0.969, P < 0.01) and 15 mm (30 s, R2-0.972, P < 0.01) grain layer thickness without significantly affecting grain quality. Cooking time and germination did not vary significantly up to 30 s of exposure, thereafter, reduced significantly. However, water uptake did not vary significantly up to 60 s of exposure. The microwave radiations are found effective for disinfestations of green gram without significantly affecting the grain quality.

Emergence of Mycobacterium orygis-Associated Tuberculosis in Wild Ruminants, India.

Tuberculosis caused by Mycobacterium orygis was detected in 2 spotted deer from a wildlife sanctuary in western India and an Indian bison from a national park in central India. Nationwide surveillance is urgently required to clarify the epidemiology of the Mycobacterium tuberculosis complex at the human-livestock-wildlife interface.

Assessment of thermal and temporal stability of SARS-CoV-2 samples using real-time qRT-PCR.

BACKGROUND: As per the guidelines of the Indian Council of Medical Research, nasopharyngeal and oropharyngeal swabs in viral transport medium (VTM) are to be stored at 4 °C for less than 5 days and for more than 5 days at -70 °C. Samples are not transported or stored as per prescribed conditions because of the limitations, resulting in an apprehensive diagnosis. The aim of the study was to test the stability of the SARS-CoV-2 sample stored in VTM at different temperatures. METHODS: In this study, the stability of 21 positive and 9 negative samples for SARS-CoV-2 was evaluated in commercial VTM at different temperatures (-80 °C, -20 °C, 4 °C, and 25 to 30 °C). Stability was checked for up to 50 days in the above storage conditions at different intervals. PathoDetect™ and Hi-PCR® kits were used for the detection of the four genes of SARS-CoV-2. The Cycle Threshold (Ct) value for determining the positivity of samples for PathoDetect™ was < 40 and for Hi-PCR® was < 38. RESULTS: The SARS-CoV-2 confirmatory genes (RdRp and E genes) and the internal housekeeping gene remained detectable even on the 50th day of the study. The Ct of the RdRp and E genes were found to increase with storage duration, but all positive samples remained positive till the end of the study, or the Ct value remained below the cut-off level. The negative samples gave consistent results until the end of the study. When the differences in Ct values were compared between the days in a set of experiments, they were not significantly different except in a few samples. CONCLUSION: The SARS-CoV-2 genetic materials in commercial VTM were stable at room temperature to -80 °C for 50 days.

Theoretical investigation of quantum capacitance of Co-doped α-MnO2 for supercapacitor applications using density functional theory.

The rapid depletion of fossil fuels and ever-growing energy demand have led to a search for renewable clean energy sources. The storage of renewable energy calls for immediate attention to the fabrication of efficient energy storage devices like supercapacitors (SCs). As an electrode material for SCs, MnO2 has gained wide research interest because of its high theoretical capacitance, variable oxidation state, vast abundance, and low cost. However, the low electric conductivity of MnO2 limits its practical application. The conductivity of MnO2 can be enhanced by tuning the electronic states through substitution doping with cobalt. In the present work, first principles analysis based on density functional theory (DFT) has been used to examine the quantum capacitance (CQC) and surface charge (Q) of Co-doped MnO2. Doping enhanced the structural stability, electrical conductivity, potential window, and quantum capacitance of α-MnO2. The shortened band gap and localized states near the Fermi level improve the CQC of α-MnO2. For the narrow potential range (-0.4 to 0.4 V), the CQC is observed to increase with doping concentration. The highest CQC value at +0.4 V is observed to be 2412.59 µF cm-2 for Mn6Co2O16 (25% doping), five times higher than that of pristine MnO2 (471.18 µF cm-2). Mn6Co2O16 also exhibits better CQC and 'Q' at higher positive bias. Hence, it can be used as an anode material for asymmetric supercapacitors. All these results suggest better capacitive performance of Co-doped α-MnO2 for aqueous SCs and as an anode material for asymmetric supercapacitors.

Value of ultrasound in assessing response to neoadjuvant chemotherapy in breast cancer.

AIM: To analyse the utility of ultrasound in assessing response to neoadjuvant chemotherapy (NAC) and predicting residual cancer burden (RCB) index and pathological complete response (pCR) MATERIALS AND METHODS: This was a retrospective study with 417 patients over 7 years. The difference in longest diameter (LD) of the index lesion from baseline to end, baseline to mid, and mid to end was evaluated with respect to RCB class using logistic regression and ordered logistic regression. RESULTS: Change in LD measurements from baseline to end, baseline to mid, and mid to end of chemotherapy as a predictor of RCB class show a negative relationship with a statistically significant association. This would suggest that a smaller change in LD measurements would be associated with an eventual higher RCB class. Change in LD measurements from baseline to end and baseline to mid chemotherapy as a predictor of pCR class show a negative relationship with a statistically significant association (p<0.05). This similarly indicates an inversely proportional relationship between changes in LD measurements and RCB class 0 for baseline to end and baseline to mid. CONCLUSION: This study has shown significance in reducing LD measurements on ultrasound as a predictor of PCR and RCB class. This adds weight to the current practice of using ultrasound at the start, mid and end of chemotherapy cycles to monitor NACT responses.

Tailoring the escape rate of a Brownian particle by combining a vortex flow with a magnetic field.

The probability per unit time for a thermally activated Brownian particle to escape over a potential well is, in general, well-described by Kramers's theory. Kramers showed that the escape time decreases exponentially with increasing barrier height. The dynamics slow down when the particle is charged and subjected to a Lorentz force due to an external magnetic field. This is evident via a rescaling of the diffusion coefficient entering as a prefactor in the Kramers's escape rate without any impact on the barrier-height-dependent exponent. Here, we show that the barrier height can be effectively changed when the charged particle is subjected to a vortex flow. While the vortex alone does not affect the mean escape time of the particle, when combined with a magnetic field, it effectively pushes the fluctuating particle either radially outside or inside depending on its sign relative to that of the magnetic field. In particular, the effective potential over which the particle escapes can be changed to a flat, a stable, and an unstable potential by tuning the signs and magnitudes of the vortex and the applied magnetic field. Notably, the last case corresponds to enhanced escape dynamics.

Implications of genetic variations, differential gene expression, and allele-specific expression on metformin response in drug-naïve type 2 diabetes.

PURPOSE: Metformin is widely used to treat type 2 diabetes mellitus (T2DM) individuals. Clinically, inter-individual variability of metformin response is of significant concern and is under interrogation. In this study, a targeted exome and whole transcriptome analysis were performed to identify predictive biomarkers of metformin response in drug-naïve T2DM individuals. METHODS: The study followed a prospective study design. Drug-naïve T2DM individuals (n = 192) and controls (n = 223) were enrolled. T2DM individuals were administered with metformin monotherapy and defined as responders and non-responders based on their glycated haemoglobin change over three months. 146 T2DM individuals were used for the final analysis and remaining samples were lost during the follow-up. Target exome sequencing and RNA-seq was performed to analyze genetic and transcriptome profile. The selected SNPs were validated by genotyping and allele specific gene expression using the TaqMan assay. The gene prioritization, enrichment analysis, drug-gene interactions, disease-gene association, and correlation analysis were performed using various tools and databases. RESULTS: rs1050152 and rs272893 in SLC22A4 were associated with improved response to metformin. The copy number loss was observed in PPARGC1A in the non-responders. The expression analysis highlighted potential differentially expressed targets for predicting metformin response (n = 35) and T2DM (n = 14). The expression of GDF15, TWISTNB, and RPL36A genes showed a maximum correlation with the change in HbA1c levels. The disease-gene association analysis highlighted MAGI2 rs113805659 to be linked with T2DM. CONCLUSION: The results provide evidence for the genetic variations, perturbed transcriptome, allele-specific gene expression, and pathways associated with metformin drug response in T2DM.

Magnetic Circular Dichroism in Archean Stratospheric Oxygen: Enantiomeric Excess of Amino Acids Produced in Volcanic Plumes.

While there is consensus that Archean atmosphere was anoxic with O2 pressure, p(O2) <10-6 PAL (present atmospheric level) at sea-level, evidence suggests that p(O2) at stratospheric altitudes of 10-50 km was orders of magnitude higher, a result of photodissociation of CO2 by UVC sunlight and incomplete mixing of O2 with other gases. Molecular O2 is paramagnetic due to triplet ground state. Magnetic circular dichroism (MCD) by stratospheric O2 is examined in earth's magnetic field and shows maximum circular polarization │(I+ - I-)│ at altitude of 15-30 km (I+/I- is intensity of left/right circularly polarized light). While (I+ - I-)/(I+ + I-) is small (~10-10), it is an unexplored source of enantiomeric excess (EE) by asymmetric photolysis of amino acid precursors produced in volcanic eruptions. The precursors reside in stratosphere for periods of over a year due to relative absence of vertical transport. Due to negligible thermal gradient across equator, they are trapped in the hemisphere where they are produced, with interhemispheric exchange time of over a year. The precursors diffuse through altitudes of maximum circular polarization before getting hydrolyzed on ground to amino acids. Enantiomeric excess of ~10-12 is calculated for precursors and amino acids. While small, this EE is orders of magnitude higher than predicted (~10-18) by parity violating energy differences (PVED) and could be the seed for growth of biological homochirality. Preferential crystallization (PC) is described as a plausible mechanism for amplification of solution EE of some amino acids from 10-12 to 10-2, for period of several days.

Sequential Amplification of Amino Acid Enantiomeric Excess by Conglomerate and Racemic Compound: Plausible Prebiotic Route Towards Homochirality.

Some amino acids can crystallize from aqueous solution both as conglomerates and racemic compounds: under high supersaturation following rapid evaporation, dissolved amino acids draining over porous sand-bars behave like conglomerates whereas in the resulting deeper pool of water, amino acid solution switches to the more common racemic-compound system. We show how the two forms might have sequentially combined under prebiotic conditions to form the basis of homochirality. The paper is a quantitative analysis of enantiomeric excess (EE) this dual behavior of amino acids is capable of producing in tandem: Initial amplification by preferential crystallization (PC) in conglomerate system (CS) followed by further amplification in the racemic compound system (RCS). Using aspartic acid as a model system, ternary phase diagram shows that a minimum supersaturation of 1.65 is required in the CS for the solution-EE to reach its maximum value of 50% at the RCS eutectic point. A relationship is derived for the dependence of this threshold supersaturation on the eutectic solubilities of CS and RCS. For given supersaturation in CS, a relation is also derived for minimum solution-EE that must be produced by PC before CS switches to RCS. Required PC-induced threshold solution-EE of 0.194, 0.070, 0.033 is calculated for supersaturation of 2, 5, 10 respectively in aspartic acid. Switching from CS to RCS further amplifies solution-EE, resulting in an overall growth of aspartic acid solution EE from near-zero in CS to around 50% in RCS.

Projections of temperature-associated mortality risks under the changing climate in an ageing society.

OBJECTIVES: This study aimed to project future temperature-associated mortality risk and additional deaths among Taiwan's elderly (aged >65 years) population. STUDY DESIGN: This study investigated retrospective temperature-mortality risk associations and future mortality projections. METHODS: A distributed lag non-linear model and random effect meta-analyses were employed to assess the risk of daily temperature-associated deaths in all-cause, circulatory, and respiratory diseases. Using the statistical downscaling temperature projections of the Representative Concentration Pathways (RCPs; i.e. RCP2.6, RCP6.0 and RCP8.5), future risk of mortalities were projected among the elderly for 2030-2039, 2060-2069 and 2090-2099, with a 30%, 40% and 50% expected increase in elderly population proportions, respectively. RESULTS: The baseline analysis from 2005 to 2018 identified that Taiwan's population is more vulnerable to cold effects than heat, with the highest cold-related mortality risk being attributed to circulatory diseases, followed by all-cause and respiratory diseases. However, future projections suggest a declining trend in cold-related mortalities and a significant rise in heat-related mortalities under different RCP scenarios. Heat-attributable mortalities under the RCP8.5 scenario by 2090-2099 would account for almost 170,360, 36,557 and 29,386 additional annual deaths among the elderly due to all-cause, circulatory and respiratory diseases, respectively. Heat-attributable all-cause mortalities among the elderly would increase by 3%, 11% and 30% under RCP2.6, RCP6.0 and RCP8.5, respectively, by 2090-2099. CONCLUSIONS: The findings of this study provide predictions on future temperature-related mortality among the elderly in a developed, ageing society with a hot and humid climate. The results from this study can guide public health interventions and policies for climate change and ageing society-associated health risks.

End-of-life solar photovoltaic panel waste management in India: forecasting and environmental impact assessment.

Presently, India is in the stage of installation of solar photovoltaic panels and no focus is being given towards the impending problem of handling solar waste. The absence of adequate regulations, guidelines and operational infrastructure for photovoltaic waste in the country may lead to waste being inappropriately landfilled or incinerated in a manner that may be detrimental to human health and the environment. Business as usual projection estimates 6.64 million tonnes and 5.48 million tonnes of waste generation due to the early and regular losses using the Weibull distribution function, respectively by 2040 in India. The current study also systematically investigates various policies and legislation developments on the end-of-life of photovoltaic modules in various regions of the world, to identify gaps for further assessment. Using life cycle assessment methodology, this paper compares the environmental impacts of landfilling end-of-life crystalline silicon panels with avoided burden approach due to the recycling of materials. It has been demonstrated that solar photovoltaic recycling and reusing the recovered materials will result in impact reduction in the forthcoming production phase by as high as 70%. Further, the outcomes of carbon footprint, single score indicator with the application of Intergovernmental Panel on Climate Change also predicts lower values for avoided burden approach due to recycling (15,393.96 kgCO2 eq) in comparison to landfill approach (19,844.054 kg CO2 eq). The outcomes of this study aim to illuminate the importance of the sustainable management of photovoltaic panels at end-of-life.

An overview for biomedical waste management during pandemic like COVID-19.

Amid COVID-19, world has gone under environmental reformation in terms of clean rivers and blue skies, whereas, generation of biomedical waste management has emerged as a big threat for the whole world, especially in the developing nations. Appropriate biomedical waste management has become a prime concern worldwide in the pandemic era of COVID-19 as it may affect environment and living organisms up to a great extent. The problem has been increased many folds because of unexpected generations of hazardous biomedical waste which needs extraordinary attentions. In this paper, the impacts and future challenges of solid waste management especially the biomedical waste management on environment and human beings have been discussed amid COVID-19 pandemic. The paper also recommends some guidelines to manage the bulk of medical wastes for the protection of human health and environment. The paper summarizes better management practices for the wastes including optimizing the decision process, infrastructure, upgrading treatment methods and other activities related with the biological disasters like COVID-19. As achieved in the past for viral disinfection, use of UV- rays with proper precautions can also be explored for COVID-19 disinfection. For biomedical waste management, thermal treatment of waste can be an alternative, as it can generate energy along with reducing waste volume by 80-95%. The Asian Development Bank observed that additional biomedical waste was generated ranged from 154 to 280 tons/day during the peak of COVID-19 pandemic in Asian megacities such as Manila, Jakarta, Wuhan, Bangkok, Hanoi, Kuala Lumpur.

Evaluation of Latex Agglutination Test for Rapid Identification of Staphylococcus aureus Isolated from Pyogenic Wound Infections at a Tertiary Care Hospital.

Background Staphylococcus aureus infections are increasingly reported worldwide. It is a major clinical problem and imposes significant morbidity and mortality due to widespread emergence of multidrug resistant pathogens like methicillin resistant Staphylococcus aureus. Thus, rapid and reliable identification of Staphylococcus aureus is essential for timely and effective management of patient. Objective The performance of Latex agglutination test (Staphaurex Plus) was compared to conventional method tube coagulase test which is gold standard too for the identification of Staphylococcus aureus. Method This study was conducted at B.P. Koirala Institute of Health Sciences. Following standard microbiological methods, isolation and identification was done in the Department of Microbiology. MRSA detection was performed following Clinical and Laboratory Standard Institute. All the isolates of Staphylococci were subjected for Latex agglutination test and was performed according to manufacturer's instructions using Staphaurex Plus kit. Result Out of 377 (methicillin sensitive Staphylococcus aureus - 142; methicillin resistant Staphylococcus aureus - 233; Coagulase Negative Staphylococci -2) isolates of Staphylococci, Latex agglutination test was found to be positive in 138 (97.1%) of methicillin sensitive Staphylococcus aureus (MSSA) and 220 (94.4%) of methicillin resistant Staphylococcus aureus (MRSA). Overall sensitivity, specificity, positive predictive value and negative predictive value of Latex agglutination test was found to be 95.46%, 100%, 100%, 10.52% respectively. Conclusion In conclusion, Latex agglutination test is a rapid and reliable test for the identification of Staphylococcus aureus.

A STUDY ON FACTORS AFFECTING THE INTENTIONS TO ACCEPT TELEMEDICINE SERVICES IN INDIA DURING COVID-19 PANDEMIC.

The goal of the current study is to comprehend the factors that influence a decision to use telemedicine for healthcare. India saw a massive surge in the use of telemedicine services in the year 2020-21, with teleconsultations increasing by almost 300%. Lockdowns and Covid-19 limitations sped up the introduction of telemedicine services. The advantages of telemedicine healthcare services, however, have not yet reached the vast majority of the population. A pilot survey is done, and a study framework is suggested, to better understand the factors that influence people's decisions to use telemedicine healthcare services. The following variables are taken into account for the study: personal norms, telemedicine use expectation, knowledge, telemedicine usage, initial satisfaction, and covid phobia -19 (CP-19). The suggested framework is then put to the test using SEM (Structural equation modelling), and a good model fit was found. Policymakers and marketers can use the findings to increase the acceptance of telemedicine healthcare services among the general public in order to promote convenience, accessibility, and healthy living.