Unraveling Factors Shaping the Acceptance and Non-acceptance of Non-scalpel Vasectomy in Rural Central India: A Cross-Sectional Study.

Background India, with a population exceeding 1.43 billion, faces significant demographic challenges, necessitating effective family planning measures. Non-scalpel vasectomy (NSV) is a less complex and cost-effective male contraceptive, yet its acceptance remains low, especially compared to female sterilization. Understanding the determinants of NSV acceptance is crucial for informed decisions on family planning methods. Methods This cross-sectional study investigated NSV acceptance among males who underwent non-scalpel vasectomy (acceptors of NSV) and spouses of women who underwent tubectomy (non-acceptors of NSV). The study was conducted among 116 NSV acceptors and 116 non-acceptors from rural Central India. Data were collected over six months, employing a pre-designed questionnaire covering socio-demographic details, reasons for acceptance/non-acceptance, and information sources for the same. Statistical analysis was done utilizing Epi Info 7.2.6 (Centers for Disease Control and Prevention [CDC], Atlanta, GA), employing descriptive statistics and tests of association. Results Significant associations were found between NSV acceptance (p<0.05) and the age and education of study subjects, age of wife, duration since marriage, and total number of children. Incentives also played a significant role (p=0.014). Opposition to NSV, mainly from wives, was a key factor for non-acceptance (38%). Reasons for acceptance included a previous cesarean section (40.52%), the simplicity of the NSV procedure (26.72%), and the wife's illness (23.28%). Non-acceptance reasons comprised family/friend opposition (38%), lack of awareness/ignorance (25.00%), and fear of surgery (23.28%). Study subjects perceived community reluctance to NSV as mainly due to misbeliefs (30.17%), fear of surgery (27.58%), and illiteracy (26.29%). Conclusion The study highlights socio-demographic factors influencing NSV acceptance and identifies key reasons for acceptance/non-acceptance. Community-based interventions, increased advertisement, and health provider counseling were suggested for enhancing acceptance. Despite challenges, participant satisfaction with NSV was high. These findings contribute to understanding the complex dynamics surrounding NSV acceptance in rural Central India, informing future family planning strategies.

Advancing proactive crash prediction: A discretized duration approach for predicting crashes and severity.

Driven by advancements in data-driven methods, recent developments in proactive crash prediction models have primarily focused on implementing machine learning and artificial intelligence. However, from a causal perspective, statistical models are preferred for their ability to estimate effect sizes using variable coefficients and elasticity effects. Most statistical framework-based crash prediction models adopt a case-control approach, matching crashes to non-crash events. However, accurately defining the crash-to-non-crash ratio and incorporating crash severities pose challenges. Few studies have ventured beyond the case-control approach to develop proactive crash prediction models, such as the duration-based framework. This study extends the duration-based modeling framework to create a novel framework for predicting crashes and their severity. Addressing the increased computational complexity resulting from incorporating crash severities, we explore a tradeoff between model performance and estimation time. Results indicate that a 15 % sample drawn at the epoch level achieves a balanced approach, reducing data size while maintaining reasonable predictive accuracy. Furthermore, stability analysis of predictor variables across different samples reveals that variables such as Time of day (Early afternoon), Weather condition (Clear), Lighting condition (Daytime), Illumination (Illuminated), and Volume require larger samples for more accurate coefficient estimation. Conversely, Daytime (Early morning, Late morning, Late afternoon), Lighting condition (Dark lighted), Terrain (Flat), Land use (Commercial, Rural), Number of lanes, and Speed converge towards true estimates with small incremental increases in sample size. The validation reveals that the model performs better in highway segments experiencing more frequent crashes (segments where the duration between crashes is less than 100 h, or approximately 4 days).

COVID-19 effects on urban driving, walking, and transit usage trends: Evidence from Indian metropolitan cities.

The outbreak of the COVID-19 pandemic disrupted all walks of life, including the transportation sector. Fear of the contagion coupled with government regulations to restrict mobility altered the travel behavior of the public. This study proposes integrating freely accessible aggregate mobility datasets published by tech giants Apple and Google, which opens a broader avenue for mobility research in the light of difficult data collection circumstances. A comparative analysis of the changes in usage of different mobility modes during the national lockdown and unlock policy periods across 6 Indian cities (Bangalore, Chennai, Delhi, Hyderabad, Mumbai, and Pune) explain the spatio-temporal differences in mode usages. The study shows a preference for individual travel modes (walking and driving) over public transit. Comparisons with pre-pandemic mode shares present evidence of inertia in the choice of travel modes. Association investigations through generalized linear mixed-effects models identify income, vehicle registrations, and employment rates at the city level to significantly impact the community mobility trends. The methods and interpretations from this study benefit government, planners, and researchers to boost informed policymaking and implementation during a future emergency demanding mobility regulations in the high-density urban conglomerations.

Consumer responses towards essential purchases during COVID-19 pan-India lockdown.

Humanity experienced one of the worst crises in recent history due to the COVID-19 pandemic. The spread of the disease and the lockdown announced by the government of India created an emergency, disrupting the supply of essential commodities and creating panic and anxiety among the people. This paper aims at capturing the behavior of consumers purchasing essential commodities before and during the lockdown using an online questionnaire. Responses from 730 households covering 20 states in India were used. The data analysis revealed that consumers made a lesser number of trips during lockdown but purchased excess commodities considering the future uncertainties. The local family grocery stores, called kirana shops served well during the pandemic. During the lockdown, consumers made shorter trips by vehicles and walked extensively. Income was found to influence purchase behavior. The disruptions at the organized retail stores for in-store as well as online purchases were identified using factor analysis. Out of the three factors identified each for in-store and online purchases, perceived risk and vendor distrust had major influence respectively. The findings of this study give pointers to many infrastructure and policy initiatives that target tackling such emergencies in the future.

Pedestrian temporal and spatial gap acceptance at mid-block street crossing in developing world.

INTRODUCTION: Most of the midblock pedestrian crossings on urban roads in India are uncontrolled; wherein the high degree of discretion in pedestrians' behavior while crossing the traffic stream, has made the situation complex to analyze. Vehicles do not yield to pedestrians, even though the traffic laws give priority to pedestrians over motorized vehicles at unsignalized pedestrian crossings. Therefore, a pedestrian has to decide if an available gap is safe or not for crossing. METHOD: This paper aims to investigate pedestrian temporal and spatial gap acceptance for midblock street crossings. Field data were collected using video camera at two midblock pedestrian crossings. The data extraction in laboratory resulted in 1107 pedestrian gaps. Available gaps, pedestrians' decision, traffic volume, etc. were extracted from the videos. While crossing a road with multiple lanes, rolling gap acceptance behavior was observed. Using binary logit analysis, six utility models were developed, three each for temporal and spatial gaps. RESULTS AND CONCLUSIONS: The 50th percentile temporal and spatial gaps ranged from 4.1 to 4.8s and 67 to 79 m respectively, whereas the 85th percentile temporal and spatial gaps ranged from 5 to 5.8s and 82 to 95 m respectively. These gap values were smaller than that reported in the studies in developed countries. The speed of conflicting vehicle was found to be significant in spatial gap but not in temporal gap acceptance. The gap acceptance decision was also found to be affected by the type of conflicting vehicles. PRACTICAL APPLICATIONS: The insights from this study can be used for the safety and performance evaluation of uncontrolled midblock street crossings in developing countries.

Vagal complex monocarboxylate transporter-2 expression during hypoglycemia.

Astrocytic provision of lactate provision to neurons may be a critical indicator of substrate fuel availability in metabolic sensing sites in the brain, including the hindbrain dorsal vagal complex. We examined the hypothesis that vagal complex monocarboxylate transporter protein levels are gender dependent and estrogen dependent, and that estrogen influences adaptation of these protein responses during repeated insulin-induced hypoglycemia. Western blot analyses showed that male and estrogen-treated ovariectomized female rats exhibit opposite changes in monocarboxylate transporter-2 levels after one insulin injection, as well as divergent patterns of adaptation to this metabolic challenge. The data suggest that sex differences in hypoglycemic patterns in vagal complex lactate transport may underlie disparate signaling of cellular energy imbalance.

Lactate is a critical "sensed" variable in caudal hindbrain monitoring of CNS metabolic stasis.

Caudal hindbrain "sensing" of glucoprivation activates central neural mechanisms that enhance systemic glucose availability, but the critical molecular variable(s) linked to detection of local metabolic insufficiency remains unclear. Central neurons and glia are metabolically coupled via intercellular trafficking of the glycolytic product lactate as a substrate for neuronal oxidative respiration. Using complementary in vivo models for experimental manipulation of lactate availability within the caudal hindbrain, we investigated the hypothesis that lactate insufficiency may be monitored by local metabolically "sensitive" neurons as an indicator of central nervous system energy imbalance. The data show that caudal fourth ventricular (CV4) administration of the monocarboxylate transporter inhibitor alpha-cyano-4-hydroxycinnamate (4CIN) resulted in dose-dependent increases in blood glucose in euglycemic animals, whereas the degree and duration of hypoglycemia elicited by insulin administration were exacerbated by exogenous L-lactate delivery to the CV4. Immunocytochemical processing of the hindbrain for the inducible c-fos gene product Fos revealed that 4CIN enhanced Fos immunoreactivity in the dorsal vagal complex (DVC), e.g., the nucleus of the solitary tract and dorsal vagal motor nucleus, and adjacent area postrema, sites where cells characterized by unique sensitivity to diminished glucose and/or glycolytic intermediate/end product levels reside, and in the medial vestibular nucleus (MV), and that CV4 L-lactate infusion increased Fos labeling within the DVC and MV after insulin-induced hypoglycemia. Together, these results support the view that lactate is a critical monitored metabolic variable in caudal hindbrain detection of energy imbalance resulting from glucoprivation and that diminished uptake and/or oxidative catabolism of this fuel activates neural mechanisms that increase systemic glucose availability.

Transcriptional activation of nucleus tractus solitarii/area postrema catecholaminergic neurons by pharmacological inhibition of caudal hindbrain monocarboxylate transporter function.

Evidence that intracerebral lactate administration alters electrophysiological sensitivity of metabolic-signaling neurons and hypoglycemic counterregulation suggests that this substrate fuel is a monitored indicator of in central nervous system energy balance. Catecholaminergic (CA) neurons in the caudal hindbrain nucleus tractus solitarii (NTS)/area postrema (AP) complex participate in the origin and/or relay of stimuli that signal deficient glucose provision to the brain. The present studies evaluated the responsiveness of this neurochemical phenotype to lactate insufficiency by investigating the effects of pharmacological inhibition of local monocarboxylate transporter activity on the transcriptional status of these cells. Adult female rats were sacrificed by transcardial perfusion 2 h after infusion of graded doses of the monocarboxylate transporter inhibitor, alpha-cyano-4-hydroxycinnamic acid (4-CIN), or vehicle into the caudal fourth ventricle, and tissue sections through the NTS/AP were processed by dual-label immunofluorescence histochemistry for demonstration of cytoplasmic tyrosine hydroxylase (TH) and the inducible nuclear AP-1 regulatory factor, Fos. While vehicle administration resulted in negligible Fos immunostaining within the NTS, 4-CIN-treated animals exhibited dose-dependent increases in mean numbers of Fos-ir- and TH-/Fos-ir-positive neurons in this structure. These data show that pharmacological suppression of lactate trafficking in the caudal hindbrain elicits the genomic activation of NTS/AP CA neurons. In light of evidence implicating this neurochemical phenotype in signaling of cellular energy imbalance, the current results support the view that diminished uptake and/or catabolism of lactate may underlie CA neuronal activation of neural pathways governing compensatory behavioral and physiological responses to metabolic substrate deficiency.

Induction of Fos immunoreactivity labeling in rat forebrain metabolic loci by caudal fourth ventricular infusion of the monocarboxylate transporter inhibitor, alpha-cyano-4-hydroxycinnamic acid.

Caudal fourth ventricular (CV4) infusion of the monocarboxylate transporter inhibitor, alpha-cyano-4-hydroxycinnamic acid (4CIN), causes hyperglycemia coincident with Fos expression in the hindbrain nucleus tractus solitarius, a rare central source of metabolic deficit signaling. The present studies examined the hypothesis that hindbrain lactoprivic signaling activates central autonomic pathways that regulate systemic glucostasis by examining the effects of this drug treatment paradigm on patterns of Fos expression in forebrain structures that integrate sensory input from metabolic sensors and coordinate motor responses to energy shortages. Two hours after CV4 infusion of graded doses of 4CIN or vehicle alone, adult female rats were sacrificed by transcardial perfusion and sections through the telencephalic and diencephalic metabolic loci were processed for Fos immunoreactivity (-ir). Fos labeling of the hypothalamic paraventricular (PVH), dorsomedial (DMH), and ventromedial (VMH) nuclei was significantly elevated, relative to the vehicle-treated controls, in response to the lowest dose of 4CIN, e.g. 10 microg/animal. Treatment with higher doses of 4CIN (25 or 50 microg) further augmented numbers of Fos-ir-positive neurons in these structures, and also elicited staining of the bed nuclei of the stria terminalis (BST), medial preoptic (MPN), arcuate (ARH), supraoptic (SO), and anterior hypothalamic nuclei (AHN), and lateral hypothalamic area (LHA). Mean numbers of Fos-immunolabeled neurons in the ARH, DMH, LHA, AHN, MPN, and SO were not different between animals infused with 25 versus 50 microg 4CIN, whereas neuronal labeling in the VMH, BST, and PVH was significantly greater in the high- versus the middle-dose groups. The present data show that pharmacological inhibition of lactate uptake within the caudal hindbrain results in dose-dependent neuronal Fos immunoexpression within characterized forebrain components of the central metabolic circuitry, and that these patterns of neuronal transcriptional activation parallel observed drug effects on blood glucose levels. These results suggest that lactoprivic signaling by metabolic 'sensing' neurons in the caudal hindbrain initiates central neural mechanisms that control systemic energy availability, and that local lactate-'sensitive' neurons are connected neuroanatomically with principal higher-order autonomic metabolic loci that regulate glucostasis.