Readiness, acceptability, and feasibility of differentiated TB care for COVID-positive pulmonary tuberculosis patients diagnosed in a district in South India: Mixed methods study.

Background: Differentiated tuberculosis care (DTC) approach is the need of the hour to mitigate those risks and provide better treatment outcomes to reduce both mortality and morbidity. Before implementing such an approach, there should be adequate literature on healthcare facility assessment along with qualitative exploration on readiness and acceptability among various stakeholders that are currently needed to fill the gaps in National Tuberculosis Elimination Program. Objectives: Our study objectives were to assess the availability of equipment, treatment, and investigations for managing patients under the DTC approach, to explore the readiness, acceptability, and feasibility of the DTC approach among healthcare providers involved in TB care provision, and to determine the knowledge regarding DTC approach among healthcare providers delivering TB care for COVID-positive pulmonary TB patients. Materials and Methods: All Peripheral Health Institutes (PHIs) in two randomly chosen blocks within the Tiruchirappalli district's health units were selected for the healthcare facilities assessment. By the universal sampling method, all the stakeholders were included. The study population was assessed for their knowledge regarding DTC. Checklist-based assessment of the feasibility of healthcare services followed by a questionnaire-based knowledge assessment was done. An in-depth interview-based exploration of readiness and acceptability of the DTC approach was conducted. This study was conducted among various stakeholders involved in TB care in selected PHIs of Tiruchirappalli from July 2022 to October 2022. Results: The majority of healthcare workers (HCWs) are unaware of bidirectional screening (89.0%) and lack training in providing TB care to COVID-co-infected patients (87.8%), although the majority were aware of risk stratification for TB patients (90.2%) and are linking TB with other co-morbidities (82.9%). About 62.2% of HCWs claimed they are not using information communication technology-based services to receive lab findings from public scans and laboratory centers, and more than one-third were unaware of these facilities. Based on the qualitative assessment, most of them were willing to undergo periodic training to improvise their approach and treatment. Also, most of the HCWs felt manpower can be increased for the specific care of the patients. Conclusion: The research suggests that with sufficient training and upskilling of the HCWs, DTC is almost feasible and that HCWs will accept it if specific strategies are used. More studies like these in assessing the feasibility and acceptability of this DTC approach and exploring the challenges and solutions will help the policymakers in finding the lacunae before implementing this DTC model in various states across India.

Designing 3D printable food based on fruit and vegetable products-opportunities and challenges.

3D printing is an innovative technology for food industry, which provides tremendous opportunities for the designing of customized and personalized nutrition for fruit and vegetable based food products. Various researchers have worked on the development of printable ink, stability of printed products and quality parameters. The aim of this review is to cover the most recent advancements on 3D food printing for fruits and vegetables and explore the prospect. Extrusion-based 3D printing is the most extensively used technique due to their several advantages. The review examines the three groups of extrusion printing such as room temperature extrusion, fused deposition manufacturing and gel forming extrusion. The development in last few years in the area of 3D food products of fruits and vegetables powder has been assembled in this review article. Based on these results, it can conclude that fruit and vegetable has been successfully used to fabricate 3D and even 4D food products. Future studies are required for improvement in pre and post-processing technique. Functional food can also be developed by using 3D printing but more research is required in this area. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-022-05386-4.

Application of ultrasonication as pre-treatment for freeze drying: An innovative approach for the retention of nutraceutical quality in foods.

Freeze drying (FD) is an important and highly effective technology in food industry for retaining the quality in final dried product. This drying technique is performed at lower temperatures, restricting the damage suffered by thermally sensitive ingredients. However, FD consumes large amount of energy and required more time than conventional drying methods. The utilization of ultrasonic technology (US) as pre-treatment before FD represents a promising alternative in accelerating the drying process, decreases energy consumption and maintaining quality as compared to the non pre-treated sample. This review summarizes research progress and current studies in ultrasonic as pre-treatment for freeze drying (US + FD) technique. The impact of US + FD on phytochemical, color, texture and micro-structure of food are well summarized. The review also suggests that the optimised US treatment parameters are required to improve heat and mass transfer in food samples which help in speed up the drying process and reduction of drying time.

Exploring the discrimination and stigma faced by transgender in Chennai city-A community-based qualitative study.

Background: Transgender people experience widespread prejudice discrimination, violence and other harms of stigma and trans-phobia (dislike of or prejudice against trans-sexual or transgender people). To study various modes in which transgenders experience the stigma and discrimination and to understand situations and circumstances under which they are vulnerable toward stigma and discrimination. Materials and Methods: The present study was a mixed-method study which was conducted during the months of January to June 2019 among 43 study participants. Focus group discussion and in-depth interview was conducted with these participants with subsequent transcription. Interpretative phenomenological analysis (IPA) was used for analysis. Results: Transgenders face discrimination and stigma in various setting including education, employment, healthcare, and various public setting. Difficulties in getting government identity cards (ID), facing difficulties in changing ID cards after transition, discrimination in getting bank loan, homelessness, travelling rejections were considered as major obstacles and discrimination by the study participants. Conclusion: Multilevel interventions are needed for transgender populations, including legal protections, improvement of various settings. Inclusive measures should be taken to improve their status focusing on social stigma coupled with psychological pain and economic hardship.

Awareness and preparedness of first responders regarding chemical, biological, radiological, nuclear and explosive (CBRNE) disaster management of a tertiary medical institute in South India: A mixed methods study.

Background: In case of a CBRNE catastrophe, junior doctors (first responders) will be the first to respond to the CBRNE disaster, so they should be fully equipped with the knowledge and skills of managing CBRNE casualties and preventing the endangerment of lives. Objectives: To assess the awareness and preparedness of first responders in medical institutions regarding CBRNE casualties' management and to explore the perceptions of first responders towards CBRNE disaster management. Materials and Methods: The present study was a mixed methods study which was conducted during the months of January to March 2020 among 153 study participants. Focus group discussions (FGDs) were conducted along with free listing and pile sorting till data saturation. Data entry was done in an Excel sheet and data analysis was be done using SPSS software v. 21. Results: Out of the 153 participants only 37 participants (24.1%) had ever heard about the term "CBRNE" (chemical, biological, radiological and nuclear disasters) or "hazmat" (hazardous material). At the end of FGDs, participants could answer affirmatively that they had heard the term "decontamination" of CBRNE casualties. Very few participants could ambiguously explain the meaning of the term "decontamination" in the context of CBRNE casualty. Conclusion: There is an imperative need for enhancing not only knowledge and awareness, but also proper training for first responders to utilizing simulation sessions. This is particularly important as health care professionals are the first line of defence when it comes to identifying and treating patients that have come into contact with CBRNE hazards.

The Association Between Gaming Practices and Scholastic Performance Among Medical Students in India: Case-Control Study.

BACKGROUND: Gaming is a billion-dollar industry that is expanding at a compound annual growth rate of 9% to 14.3%, with the biggest market in Southeast Asian countries. The availability of low-cost smartphones and the ease at which the internet can be accessed have made gaming popular among youth, who enjoy it as a leisure activity. According to the World Health Organization, excessive indulgence in gaming can lead to gaming disorder. Medical students indulging in excessive gaming can succumb to gaming disorder, which can affect their scholastic performance. OBJECTIVE: This study aimed to assess the association between gaming practices and scholastic performance among medical students. METHODS:  This study used a case-control design, where 448 medical undergraduate students (first year to prefinal) were preliminarily surveyed using universal sampling on their gaming practices in the last 6 months. Out of this sample, the 91 participants who admitted to gaming in the past 6 months were recruited as cases, while participants who never engaged in gaming in the last 6 months were recruited as controls. Both the cases and controls were matched for age and gender in a 1:1 ratio. The internal assessment scores (based on 2 midterms completed in the last 6 months) of cases and controls were compared. The Snedecor F test was used to determine the association between the number of hours spent gaming and internal assessment scores (%), while the Student t test was used to determine significant differences between the internal assessment scores of cases and controls. Odds ratios were calculated to identify the risk of poor scholastic performance among cases compared to the controls. The prevalence of gaming disorder among cases was assessed using the Gaming Addiction Scale (GAS). RESULTS: The frequency of gaming (in hours) was not associated with mean internal assessment scores (P=.13). Male cases reported significantly lower internal assessment scores compared to male controls (P=.005 vs P=.01), whereas no significant differences were observed between the internal assessment scores of female cases and controls (P=.89 vs P=.59). A negative correlation was observed between GAS scores and internal assessment scores (r=-0.02). The prevalence of gaming disorder using the GAS was observed to be 6.3% (28/448) in the study population and 31% (28/91) among cases. The risk of low scores (<50%) among gamers was observed to be 1.9 (95% CI 1.04-3.44, P=.03) times higher in the first midterm and 1.80 (95% CI 0.97-3.36, P=.06) times higher in the second midterm compared to nongamers. CONCLUSIONS: The findings suggest that excessive gaming adversely affects the scholastic performance of male participants more than female participants. Awareness about gaming disorder needs to be created among students, parents, and teachers. Treatment services should be made available to medical students with gaming disorders.

Ultrasonic treatment: A cohort review on bioactive compounds, allergens and physico-chemical properties of food.

Implementation of ultrasonic for the extraction of bioactive compounds and retention of physico-chemical properties is an important technology. This technology applies physical and chemical phenomena for the extraction of compounds. Ultrasonic assisted extraction causes less damaging effect on quality properties of food as compared to the conventional extraction technique. The present review article focuses on the degradation of various bioactive compounds as a result of ultra-sonication which include vitamins, carotenoids and phenolic compounds. This review article also discusses the influence of ultrasonic extraction on the physico-chemical properties of extracted food products. In addition, the paper explores the effect of ultrasonication on food allergenicity through changes in solubility, hydrophobicity, molecular weight as well as conformational changes of the allergens, a direct result of increase in temperature and pressure during cavitation process.