Modeling maize growth and nitrogen dynamics using CERES-Maize (DSSAT) under diverse nitrogen management options in a conservation agriculture-based maize-wheat system.

Agricultural field experiments are costly and time-consuming, and often struggling to capture spatial and temporal variability. Mechanistic crop growth models offer a solution to understand intricate crop-soil-weather system, aiding farm-level management decisions throughout the growing season. The objective of this study was to calibrate and the Crop Environment Resource Synthesis CERES-Maize (DSSAT v 4.8) model to simulate crop growth, yield, and nitrogen dynamics in a long-term conservation agriculture (CA) based maize system. The model was also used to investigate the relationship between, temperature, nitrate and ammoniacal concentration in soil, and nitrogen uptake by the crop. Additionally, the study explored the impact of contrasting tillage practices and fertilizer nitrogen management options on maize yields. Using field data from 2019 and 2020, the DSSAT-CERES-Maize model was calibrated for plant growth stages, leaf area index-LAI, biomass, and yield. Data from 2021 were used to evaluate the model's performance. The treatments consisted of four nitrogen management options, viz., N0 (without nitrogen), N150 (150 kg N/ha through urea), GS (Green seeker-based urea application) and USG (urea super granules @150kg N/ha) in two contrasting tillage systems, i.e., CA-based zero tillage-ZT and conventional tillage-CT. The model accurately simulated maize cultivar's anthesis and physiological maturity, with observed value falling within 5% of the model's predictions range. LAI predictions by the model aligned well with measured values (RMSE 0.57 and nRMSE 10.33%), with a 14.6% prediction error at 60 days. The simulated grain yields generally matched with measured values (with prediction error ranging from 0 to 3%), except for plots without nitrogen application, where the model overestimated yields by 9-16%. The study also demonstrated the model's ability to accurately capture soil nitrate-N levels (RMSE 12.63 kg/ha and nRMSE 12.84%). The study concludes that the DSSAT-CERES-Maize model accurately assessed the impacts of tillage and nitrogen management practices on maize crop's growth, yield, and soil nitrogen dynamics. By providing reliable simulations during the growing season, this modelling approach can facilitate better planning and more efficient resource management. Future research should focus on expanding the model's capabilities and improving its predictions further.

Pandemic treaty as an instrument to strengthen global health security: Global health diplomacy at its crux.

Background: The World Health Assembly (WHA), on 1st December 2021, unanimously agreed to launch a global process to draft and negotiate a convention, agreement, or other international instrument under the World Health Organization's (WHO's) constitution to strengthen pandemic prevention, preparedness, and response. We aimed to explore the role of global health diplomacy (GHD) in pandemic treaty negotiations by providing deep insight into the ongoing drafting process under the WHO leadership. Methods: We conducted a narrative review by searching Scopus, Web of Sciences, PubMed, MEDLINE, and Google Scholar search engine using the keywords "Pandemic Treaty," OR "International Health Regulations," OR "International conventions," OR "International treaties" in the context of recent COVID-19 pandemic. Besides, we included articles recommending the need for GHD, leadership and governance mechanisms for this international treaty drafting approved by the WHA. Results: Amid the COVID-19 pandemic, the concept of GHD bolstered the international system and remained high on the agendas of many national, regional and global platforms. As per Article 19 of the WHO constitution, the Assembly established an intergovernmental negotiating body (INB) to draft and negotiate this convention/ agreement to protect the world from disease outbreaks of pandemic potential. Since GHD has helped to strengthen international cooperation in health systems and address inequities in achieving health-related global targets, there is a great scope for the successful drafting of this pandemic treaty. Conclusion: The pandemic treaty is a defining moment in global health governance, particularly the pandemic governance reforms. However, the treaty's purpose will only be served if the equity considerations are optimized, accountability mechanisms are established, and a sense of shared responsibility is embraced. While fulfilling treaty commitments might be complex and challenging, it provides an opportunity to rethink and build resilient systems for pandemic preparedness and response in the future.

Evaluation of Comparative Efficacy and Safety of Surgical Approaches for Total Hip Arthroplasty: A Systematic Review and Network Meta-analysis.

Importance: Each approach for primary total hip arthroplasty (THA) has a long learning curve, so a surgeon's choice to change their preferred approach needs to be guided by clear justifications. However, current evidence does not suggest that any of the THA approaches are more beneficial than others, and the choice of approach is mainly based on the knowledge and experience of the surgeon and individual patient characteristics. Objective: To assess the efficacy and safety associated with different surgical approaches for THA. Data Sources: A comprehensive search of PubMed, EMBASE, and Cochrane databases from inception to March 26, 2022; reference lists of eligible trials; and related reviews. Study Selection: Randomized clinical trials (RCTs) comparing different surgical approaches, including the 2-incision approach, direct anterior approach (DAA), direct lateral approach (DLA), minimally invasive direct lateral approach (MIS-DLA), minimally invasive anterolateral approach (MIS-ALA), posterior approach (PA), minimally invasive posterior approach (MIS-PA), and supercapsular percutaneously assisted total hip arthroplasty (SuperPath), for primary THA. Data Extraction and Synthesis: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 2 reviewers independently extracted data on study participants, interventions, and outcomes as well as assessed the risk of bias using the Cochrane risk of bias tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. A frequentist framework was used to inform a series of random-effects network meta-analyses. Main Outcomes and Measures: The outcomes were hip score (range, 0-100, with higher scores indicating better overall hip condition), pain score (range, 0-100, with higher scores indicating more pain), hospitalization time, operation time, quality of life score, blood loss, cup abduction angle, and cup anteversion angle. Results: Of 2130 retrieved studies, 63 RCTs including 4859 participants (median [IQR] age, 64.0 [60.3-66.5] years; median [IQR] percentage male, 46.74% [38.64%-54.74%]) were eligible for analysis. Eight surgical approaches were evaluated. For hip score, DAA (mean difference [MD], 4.04; 95% CI, 1.92 to 6.16; moderate certainty), MIS-ALA (MD, 3.00; 95% CI, 0.43 to 5.59; moderate certainty), MIS-DLA (MD, 3.37; 95% CI, 1.05 to 5.68; moderate certainty), MIS-PA (MD, 4.46; 95% CI, 1.60 to 7.31; moderate certainty), PA (MD, 4.37; 95% CI, 1.87 to 6.88; high certainty), and SuperPath (MD, 5.00; 95% CI, 0.58 to 9.42; high certainty) were associated with greater improvement in hip score compared with DLA. DLA was associated with lower decrease in pain score than SuperPath (MD, 1.16; 95% CI, 0.13 to 2.20; high certainty) and MIS-DLA (MD, 0.90; 95% CI, 0.04 to 1.76; moderate certainty). PA was associated with shorter operation times compared with 2-incision (MD, -23.85 minutes; 95% CI, -36.60 to -11.10 minutes; high certainty), DAA (MD, -13.94 minutes; 95% CI, -18.79 to -9.08 minutes; moderate certainty), DLA (MD, -10.50 minutes; 95% CI, -16.07 to -4.94 minutes; high certainty), MIS-ALA (MD, -6.76 minutes; 95% CI, -12.86 to -0.65 minutes; moderate certainty), and SuperPath (MD, -13.91 minutes; 95% CI, -21.87 to -5.95 minutes; moderate certainty). The incidence of 6 types of complications did not differ significantly between the approaches. Conclusions and Relevance: In this study, moderate to high certainty evidence indicated that compared with PA, all surgical approaches except DLA were associated with similar improvements of hip score but longer operation time. DLA was associated with smaller improvement of hip score. The safety of the different approaches did not show significant differences. These findings will help health professionals and patients with better clinical decision-making and also provide references for policy makers.

The rise of India's global health diplomacy amid COVID-19 pandemic.

The COVID-19 pandemic has highlighted the importance of global health diplomacy (GHD), with India emerging as a key player. India's commitment to GHD is demonstrated by its active participation in regional and multilateral projects, pharmaceutical expertise, and large-scale manufacturing capabilities, which include the production and distribution of COVID-19 vaccines and essential medicines. India has supported nations in need through bilateral and multilateral platforms, providing vaccines to countries experiencing shortages and offering technical assistance and capacity-building programs to improve healthcare infrastructure and response capabilities. India's unique approach to GHD, rooted in humanitarian diplomacy, emphasized collaboration and empathy and stressed the well-being of humanity by embracing the philosophy of "Vasudhaiva Kutumbakam," which translates to "the world is one family." Against this background, this paper's main focus is to analyze the rise of India's GHD amidst the COVID-19 pandemic and its leadership in addressing various global challenges. India has demonstrated its commitment to global solidarity by offering medical supplies, equipment, and expertise to more than 100 countries. India's rising global leadership can be attributed to its proactive approach, humanitarian diplomacy, and significant contributions to global health initiatives.

Improving WHO's understanding of WHO guideline uptake and use in Member States: a scoping review.

BACKGROUND: WHO publishes public health and clinical guidelines to guide Member States in achieving better health outcomes. Furthermore, WHO's Thirteenth General Programme of Work for 2019-2023 prioritizes strengthening its normative functional role and uptake of normative and standard-setting products, including guidelines at the country level. Therefore, understanding WHO guideline uptake by the Member States, particularly the low- and middle-income countries (LMICs), is of utmost importance for the organization and scholarship. METHODS: We conducted a scoping review using a comprehensive search strategy to include published literature in English between 2007 and 2020. The review was conducted between May and June 2021. We searched five electronic databases including CINAHL, the Cochrane Library, PubMed, Embase and Scopus. We also searched Google Scholar as a supplementary source. The review adhered to the PRISMA-ScR (PRISMA extension for scoping reviews) guidelines for reporting the searches, screening and identification of evaluation studies from the literature. A narrative synthesis of the evidence around key barriers and challenges for WHO guideline uptake in LMICs is thematically presented. RESULTS: The scoping review included 48 studies, and the findings were categorized into four themes: (1) lack of national legislation, regulations and policy coherence, (2) inadequate experience, expertise and training of healthcare providers for guideline uptake, (3) funding limitations for guideline uptake and use, and (4) inadequate healthcare infrastructure for guideline compliance. These challenges were situated in the Member States' health systems. The findings suggest that governance was often weak within the existing health systems amongst most of the LMICs studied, as was the guidance provided by WHO's guidelines on governance requirements. This challenge was further exacerbated by a lack of accountability and transparency mechanisms for uptake and implementation of guidelines. In addition, the WHO guidelines themselves were either unclear and were technically challenging for some health conditions; however, WHO guidelines were primarily used as a reference by Member States when they developed their national guidelines. CONCLUSIONS: The challenges identified reflect the national health systems' (in)ability to allocate, implement and monitor the guidelines. Historically this is beyond the remit of WHO, but Member States could benefit from WHO implementation guidance on requirements and needs for successful uptake and use of WHO guidelines.

Advancing African Medicines Agency through Global Health Diplomacy for an Equitable Pan-African Universal Health Coverage: A Scoping Review.

The African continent is home to 15% of the world's population and suffers from a disease burden of more than 25% globally. In this COVID-19 era, the high burden and mortality are further worsened due to inequities, inequalities such as inadequate health systems, scarce financial and human resources, as well as unavailability of inexpensive medicines of good quality, safety, and efficacy. The Universal Health Coverage ensures that people have access to high-quality essential health services, secure, reliable, and affordable essential medicines and vaccines, as well as financial security. This paper aimed at addressing the critical need for a continental African Medicines Agency (AMA) in addressing the inequities and the role of global health diplomacy in building consensus to support the ratification of the Treaty of AMA. A literature review was done in Scopus, Web of Science, MEDLINE/PubMed, and Google Scholar search engine to identify the critical literature in the context of study objectives. All the articles published after 2015 till 2021 in the context of AMA were included. African Health Strategy 2016-2030 highlighted the importance of an African regulatory mechanism for medicines and medical products. Through global health diplomacy (GHD), the African Union and its partners can negotiate and cooperate in providing infrastructural, administrative, and regulatory support for establishing the AMA. The paper emphasizes the South-South cooperation and highlights the contributions of India and China in the supply of medicines and vaccines to Africa. A strong AMA created through GHD can be a vital instrument in utilizing Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities extension and an ideal partner for European and other regional regulatory authorities seeking to stem the tide of counterfeit, sub-standard, or fake products.

Canada's response to international travel during COVID-19 pandemic - a media analysis.

BACKGROUND: The media play a critical role in informing the public about the COVID-19 pandemic. Throughout the pandemic, international travel has been a highly contested subject at both the international and national levels. We examined Canadian media reporting on international travel restrictions during the pandemic, how these restrictions aligned with the International Health Regulations (IHR 2005), and how the narrative around international travel evolved over time. METHODS: We analysed articles from Canada's top three national newspapers by circulation - The Globe and Mail, The National Post and The Toronto Star - published between Jan 1, 2020 - May 31, 2020. Our search yielded a total of 378 articles across the three newspapers. After removing duplicates and screening the remaining articles, we included a total of 62 articles for the analysis. We conducted a qualitative media content analysis by using an inductive coding approach. RESULTS: Three major themes were identified within the articles. These included: 1) The role of scientific and expert evidence in implementing travel restrictions; 2) Federal legislation, regulation and enforcement of international travel measures; and 3) Compliance with World Health Organization (WHO) guidelines in travel restriction policy- and decision-making. The federal government relied primarily on scientific evidence for implementing international travel restrictions and fully exercised its powers under the Quarantine Act to enforce travel regulations and comply with the IHR 2005. The government embraced a rules-based international order by following WHO recommendations on international travel, contributing to a delay in border closure and travel restrictions until mid-March. CONCLUSION: The media focussed significantly on international travel-related issues during the early phase of the pandemic. The dominant media narrative surrounded the need for earlier travel restrictions against international travel.

Politics of disease control in Africa and the critical role of global health diplomacy: A systematic review.

Background: Africa is facing the triple burden of communicable diseases, non-communicable diseases (NCDs), and nutritional disorders. Multilateral institutions, bilateral arrangements, and philanthropies have historically privileged economic development over health concerns. That focus has resulted in weak health systems and inadequate preparedness when there are outbreaks of diseases. This review aims to understand the politics of disease control in Africa and global health diplomacy's (GHD's) critical role. Methods: A literature review was done in Medline/PubMed, Web of Science, Scopus, Embase, and Google scholar search engines. Keywords included MeSH and common terms related to the topics: "Politics," "disease control," "epidemics/ endemics," and "global health diplomacy" in the "African" context. The resources also included reports of World Health Organization, United Nations and resolutions of the World Health Assembly (WHA). Results: African countries continue to struggle in their attempts to build health systems for disease control that are robust enough to tackle the frequent epidemics that plague the continent. The politics of disease control requires the crafting of cooperative partnerships to accommodate the divergent interests of multiple actors. Recent outbreaks of COVID-19 and Ebola had a significant impact on African economies. It is extremely important to prioritize health in the African development agendas. The African Union (AU) should leverage the momentum of the rise of GHD to (i) navigate the politics of global health governance in an interconnected world(ii) develop robust preparedness and disease response strategies to tackle emerging and reemerging disease epidemics in the region (iii) address the linkages between health and broader human security issues driven by climate change-induced food, water, and other insecurities (iv) mobilize resources and capacities to train health officials in the craft of diplomacy. Conclusion: The AU, Regional Economic Communities (RECs), and African Centres for Disease Control should harmonize their plans and strategies and align them towards a common goal that integrates health in African development agendas. The AU must innovatively harness the practice and tools of GHD towards developing the necessary partnerships with relevant actors in the global health arena to achieve the health targets of the Sustainable Development Goals.

The TB REACH Initiative: Supporting TB Elimination Efforts in the Asia-Pacific.

After many years of TB 'control' and incremental progress, the TB community is talking about ending the disease, yet this will only be possible with a shift in the way we approach the TB response. While the Asia-Pacific region has the highest TB burden worldwide, it also has the opportunity to lead the quest to end TB by embracing the four areas laid out in this series: using data to target hotspots, initiating active case finding, provisioning preventive TB treatment, and employing a biosocial approach. The Stop TB Partnership's TB REACH initiative provides a platform to support partners in the development, evaluation and scale-up of new and innovative technologies and approaches to advance TB programs. We present several approaches TB REACH is taking to support its partners in the Asia-Pacific and globally to advance our collective response to end TB.

Corrected and Republished: Global Health Diplomacy Fingerprints on Human Security.

Human security is a concept that challenges the traditional notion of national security by placing the 'human' as the central referent of security instead of the 'state.' It is a concept that encompasses health and well-being of people and prioritizes their fundamental freedoms and basic livelihoods by shielding them from acute socioeconomic threats, vulnerabilities and stress. The epicenter of "health security" is located at the intersection of several academic fields or disciplines which do not necessarily share a common theoretical approach. Diverse players in the "health security" domain include practitioners in such fields as security studies, foreign policy, international relations, development theory, environmental politics and the practices of the United Nations system and other multilateral bodies like the World Health Organization (WHO) and the Pan American Health Organization (PAHO). Improvements in health are not only dependent on continued commitments to enhance the availability of healthcare and to strengthen disease prevention systems; they are very much enhanced by that intersection between global security and global health. What is emerging is global health diplomacy paradigm that calls for strengthening of core capacities in the public health and foreign policy arenas aimed at advancing human security through the strengthening of global health diplomacy practices. Human security in its broadest sense embraces far more than the absence of violence and conflict. It encompasses human rights, good governance, access to education and health care, and ensuring that each individual has opportunities and devices to fulfill his or her potential. Every step in this direction is a step towards reducing poverty, achieving growth and preventing conflict. Freedom from want, freedom from fear and the freedom of future generations to inherit a natural environment - these are the interrelated building blocks of human- and therefore national security.

Ending TB in Southeast Asia: current resources are not enough.

The Southeast Asia Region continues to battle tuberculosis (TB) as one of its most severe health and development challenges. Unless there is a substantial increase in investments for TB prevention, diagnosis, care and treatment, there will be catastrophic effects for the region. The uncontrolled TB burden impacts socioeconomic development and increase of drug resistance in the region. Based on epidemiological inputs from a mathematical model, a costing analysis estimates that the desired targets of ending TB are achievable with additional interventions, and critical thresholds require an increase in spending by almost double the current levels. The data source for financial allocation to TB programmes is the report submitted by countries to WHO, while projections are based on modelling. The model accounts for funding needs for all strategies based on published data and accounts for programme and patient costs. This paper delineates the resource needs, availability and gaps of ending TB in the region. It is estimated that close to US$2 billion per year are needed in the region for TB-related activities for a meaningful bending of the incidence curve towards ending TB.

Global Health Diplomacy Fingerprints on Human Security.

Human security is a concept that challenges the traditional notion of national security by placing the 'human' as the central referent of security instead of the 'state.' It is a concept that encompasses health and well-being of people and prioritizes their fundamental freedoms and basic livelihoods by shielding them from acute socioeconomic threats, vulnerabilities and stress. The epicenter of "health security" is located at the intersection of several academic fields or disciplines which do not necessarily share a common theoretical approach. Diverse players in the "health security" domain include practitioners in such fields as security studies, foreign policy, international relations, development theory, environmental politics and the practices of the United Nations system and other multilateral bodies like the World Health Organization (WHO) and the Pan American Health Organization (PAHO). Improvements in health are not only dependent on continued commitments to enhance the availability of healthcare and to strengthen disease prevention systems; they are very much enhanced by that intersection between global security and global health. What is emerging is global health diplomacy paradigm that calls for strengthening of core capacities in the public health and foreign policy arenas aimed at advancing human security through the strengthening of global health diplomacy practices. Human security in its broadest sense embraces far more than the absence of violence and conflict. It encompasses human rights, good governance, access to education and health care, and ensuring that each individual has opportunities and devices to fulfill his or her potential. Every step in this direction is a step towards reducing poverty, achieving growth and preventing conflict. Freedom from want, freedom from fear and the freedom of future generations to inherit a natural environment - these are the interrelated building blocks of human- and therefore national security.

Community matters - why outbreak responses need to integrate health promotion.

Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

Voices of decision makers on evidence-based policy: A case of evolving TB/HIV co-infection policy in India.

This study explores decision makers' perspectives on evidence-based policy (EBP) development using the case of TB/HIV co-infection in India. Twelve in-depth interviews were conducted with purposively selected key national and international policy decision makers in India. Verbatim transcripts were processed and analysed thematically using QSR (NUD*IST 6). The decision makers were unequivocal in recognizing the TB/HIV co-infection as an important public health issue in India and stated the problem to be different than Africa. The need of having a "third programme" for co-infection was not felt. According to them, the public health management of this co-infection must be within the realm of these two programmes. The study also emphasized on decision makers' perspectives on evidence and the process of utilization of evidence for decision-making for co-infection. Study findings showed global evidence was not always accepted by the decision makers and study shows several examples of decision makers demanding local evidence for policy decisions. Decision makers did make interim policies based on global evidence but most of the time their mandate was to get local evidence. Thus, operations research/implementation science especially multi-centric studies emerge as important strategy for EBP development. Researcher-policy maker interface was a gap where role of researcher as aggressive communicator of research findings was expected.

Influence of antioxidant rich fresh vegetable juices on starch induced postprandial hyperglycemia in rats.

This research analyzed the major chemical components and multiple antioxidant activities present in the fresh juice of eight vegetables, and studied their influence on starch induced postprandial glycemia in rats. A SDS-PAGE based protein fingerprint of each vegetable juice was also prepared. The yields of juice, chemical components like total proteins, total polyphenols, total flavonoids, total anthocyanins and free radicals like the ABTS˙(+) cation, DPPH, H(2)O(2), scavenging activities and reducing properties for NBT and FeCl(3) showed wide variations. Vegetable juice from brinjal ranked first in displaying total antioxidant capacity. Pretreatment of rats with vegetable juices moderated starch induced postprandial glycemia. The fresh juice from the vegetables ridge gourd, bottle gourd, ash gourd and chayote significantly mitigated postprandial hyperglycemic excursion. Total polyphenol concentrations present in vegetable juices positively influenced ABTS˙(+) scavenging activity and total antioxidant capacity. However, NBT reducing activity of juices was positively affected by total protein concentration. Contrarily, however, high polyphenol content in vegetable juice was observed to adversely affect the postprandial antihyperglycemic activity of vegetable juices. This is the first report exploring antihyperglycemic activity in these vegetable juices and highlights the possible adverse influence of high polyphenol content on the antihyperglycemic activity of the vegetable juices.

Optimizing adherence to antiretroviral therapy.

HIV has now become a manageable chronic disease. However, the treatment outcomes may get hampered by suboptimal adherence to ART. Adherence optimization is a concrete reality in the wake of 'universal access' and it is imperative to learn lessons from various studies and programmes. This review examines current literature on ART scale up, treatment outcomes of the large scale programmes and the role of adherence therein. Social, behavioural, biological and programme related factors arise in the context of ART adherence optimization. While emphasis is laid on adherence, retention of patients under the care umbrella emerges as a major challenge. An in-depth understanding of patients' health seeking behaviour and health care delivery system may be useful in improving adherence and retention of patients in care continuum and programme. A theoretical framework to address the barriers and facilitators has been articulated to identify problematic areas in order to intervene with specific strategies. Empirically tested objective adherence measurement tools and approaches to assess adherence in clinical/ programme settings are required. Strengthening of ART programmes would include appropriate policies for manpower and task sharing, integrating traditional health sector, innovations in counselling and community support. Implications for the use of theoretical model to guide research, clinical practice, community involvement and policy as part of a human rights approach to HIV disease is suggested.

Hyper IgE Disorder Associated with Multiple Fused Primary Teeth: A Rare Clinical Occurrence.

The hyperimmunoglobulin E syndrome (HIES) is a multisystem disorder that affects the dentition, skeleton, connective tissues and immune system. Little is known about oral manifestations of the syndrome. The purpose of this report was to describe a 6-year-old boy with suspected autosomal recessive HIES syndrome who had multiple fused primary teeth, which is a rare association with JOB syndrome. The patient gave a history of pneumonia and skin infections. Recognition of such case at an early age is necessary to reduce morbidity. As conclusion, treatment for this condition is life long administration of therapeutic doses of penicillinase-resistant penicillin, with the addition of other antibiotics or antifungal agents as required for specific infections.