Digital health for all: The turn to digitized healthcare in India.

In India, the use of digital technologies has become the key to the everyday operation of the welfare state in terms of accessing essential and life-sustaining entitlements. In this context, our article explores the genesis of India's digital turn in healthcare and maps the characteristics of a 'digital health for all' policy, based on empirical analysis of India's first digital-based universal health coverage programme - Rashtriya Swasthya Bima Yojana (RSBY) - with fieldwork material from the states of Jharkhand and Chhattisgarh. Being a smart-card-centred programme, RSBY marks the genesis of a digital approach to healthcare in India. The experiences of this scheme hold crucial implications for the digital healthcare landscape in India, as in the past its promoters pitched for its use to provide quality healthcare at lower cost. The technological design of the programme illustrates the construction and politics of a digitalized public-private welfare policy intended to meet the health needs of the poorest. By examining data on digital access to healthcare in the RSBY programme, as propounded and sustained by public health policies and a public-private model of governance, our article raises questions about the construction of new digital health policies and their contribution to private health markets. In doing so, it explores the key question of how digital technologies are transforming access to healthcare in India.

High-throughput Analysis of Synaptic Activity in Electrically Stimulated Neuronal Cultures.

Synaptic dysfunction is a hallmark of various neurodegenerative and neurodevelopmental disorders. To interrogate synapse function in a systematic manner, we have established an automated high-throughput imaging pipeline based on fluorescence microscopy acquisition and image analysis of electrically stimulated synaptic transmission in neuronal cultures. Identification and measurement of synaptic signal fluctuations is achieved by means of an image analysis algorithm based on singular value decomposition. By exploiting the synchronicity of the evoked responses, the algorithm allows disentangling distinct temporally correlated patterns of firing synapse populations or cell types that are present in the same recording. We demonstrate the performance of the analysis with a pilot compound screen and show that the multiparametric readout allows classifying treatments by their spatiotemporal fingerprint. The image analysis and visualization software has been made publicly available on Github ( https://www.github.com/S3Toolbox ). The streamlined automation of multi-well image acquisition, electrical stimulation, analysis, and meta-data warehousing facilitates large-scale synapse-oriented screens and, in doing so, it will accelerate the drug discovery process.

Symmetric spike timing-dependent plasticity at CA3-CA3 synapses optimizes storage and recall in autoassociative networks.

CA3-CA3 recurrent excitatory synapses are thought to play a key role in memory storage and pattern completion. Whether the plasticity properties of these synapses are consistent with their proposed network functions remains unclear. Here, we examine the properties of spike timing-dependent plasticity (STDP) at CA3-CA3 synapses. Low-frequency pairing of excitatory postsynaptic potentials (EPSPs) and action potentials (APs) induces long-term potentiation (LTP), independent of temporal order. The STDP curve is symmetric and broad (half-width ∼150 ms). Consistent with these STDP induction properties, AP-EPSP sequences lead to supralinear summation of spine [Ca(2+)] transients. Furthermore, afterdepolarizations (ADPs) following APs efficiently propagate into dendrites of CA3 pyramidal neurons, and EPSPs summate with dendritic ADPs. In autoassociative network models, storage and recall are more robust with symmetric than with asymmetric STDP rules. Thus, a specialized STDP induction rule allows reliable storage and recall of information in the hippocampal CA3 network.

Cytological diagnosis of microfilariae in filariasis endemic areas of eastern Uttar Pradesh.

BACKGROUND: Filariasis is a major health problem in tropical countries including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. AIM: To assess the role of fine needle aspiration cytology (FNAC) in diagnosis of filariasis at all possible sites. MATERIALS AND METHODS: Total 250 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. RESULTS: Out of 250 cases, 24 cases of filariasis were detected which include breast lumps (8 cases), lymph nodes (6 cases), scrotal swellings (4 cases), thyroid swellings (3 cases), soft tissue swellings (2 cases) and ascitic fluid (1 case). Eosinophilia was present in 8 out of 24 cases with a percentage ranging from 12-24%. Significant adherence of inflammatory cells and macrophages to microfilariae was present in 3 out of 24 cases. CONCLUSIONS: In endemic areas, it should be considered one of the differential diagnoses of a superficial swelling. Careful screening of FNAC smears help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment.

Critical analysis of cell block versus smear examination in effusions.

OBJECTIVES: To assess the utility of the cell block preparation method in increasing the sensitivity of cytodiagnosis of serous fluids and to know the primary site of malignant effusions. MATERIALS AND METHODS: A total of 190 cases were subjected to routine smear examination as well as cell block preparation. After the cytological diagnosis, each case was objectively analysed for cellularity, arrangement (acini, papillae, cell balls, and proliferation spheres), cytoplasmic, and nuclear details. RESULTS: Out of 190 cases, 70 cases were found to be malignant and had been examined in smears and paraffin-embedded cell blocks. Using a combination of the cell block and smear techniques yielded 13% more malignant cases than what were detected using smears by themselves. The combined technique helped to ascertain the primary site of malignancy in 83.3% of the cases, whereas the primary site could not be ascertained in 17.7% of the cases. CONCLUSIONS: The cell block technique not only increased the positive results, but also helped to demonstrate better architectural patterns, which could be of great help in making correct diagnosis of the primary site. The cell block technique was also useful for special stains and immunohistochemistry and can give morphological details by preserving the architectural patterns.