Determinants of substance use among young people attending primary health centers in India.

Background: Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods: A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results: The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions: High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

Lattice instability and magnetic phase transitions in strongly correlated MnAs.

Using variable temperature x-ray total scattering in magnetic field, we study the interaction between lattice and magnetic degrees of freedom in MnAs, which loses its ferromagnetic order and hexagonal ('H') lattice symmetry at 318 K to recover the latter and become a true paramagnet when the temperature is increased to 400 K. Our results show that the 318 K transition is accompanied by highly anisotropic displacements of Mn atoms that appear as a lattice degree of freedom bridging the 'H' and orthorhombic phases of MnAs. This is a rare example of a lowering of an average crystal symmetry due to an increased displacive disorder emerging on heating. Our results also show that magnetic and lattice degrees of freedom appear coupled but not necessarily equivalent control variables for triggering phase transitions in strongly correlated systems in general and in particular in MnAs.

Urban-rural disparities in blood pressure and lifestyle risk factors of hypertension among Indian individuals.

Objectives: This study aims to assess the urban-rural difference in prevalence of hypertension (HT) and to explore the disparities in lifestyle risk factors of HT among urban and rural individuals aged 15-49 years in India. Study Design: The cross-sectional data collected as a part of the fourth round of National Family Health Survey (NFHS-4) was analysed in this observational study. NFHS-4 was conducted between January 2015 and December 2016 amongst men aged 15-54 years and women aged 15-49 years. In order to maintain uniformity, age group of 15-49 years was considered. Descriptive analyses were performed for sociodemographic and lifestyle factors. Binary logistic regression was conducted to assess the predictors of HT in men and women in urban and rural settings. The presence of HT was considered as the outcome variable. Results: The overall age adjusted prevalence of HT was 17.2% and was greater in urban (18.3%) than in rural population (15.5%). The age adjusted prevalence was also higher in males (18.2%) as compared to females (16.1%). Age and wealth were associated with HT in both urban and rural population. Education and dietary habits played a role in all except rural men. Alcohol consumption, diabetic status and marital status were significantly associated with HT in both urban and rural women. Occupation was associated with HT only in urban women. Conclusions: The study has shown higher HT prevalence in urban areas despite higher prevalence of lifestyle risk factors in rural settings. This calls for more robust screening and health education in the entire population, especially in rural areas.

Prevalence and associated factors for awareness of hypertension in India: Findings from national survey-4.

Background: Despite the fact that hypertension is increasing, merely 50% are aware of the disease. Being aware of hypertension is important to control it. Aim: The study's objective was to estimate the level of hypertension awareness in India and explore its associated sociodemographic factors. Materials and Methods: The data collected in National Family Health Survey 4 (2015-2016) among men aged 15-54 years and women aged 15-49 years were analyzed. Taking awareness of hypertension as an outcome variable, descriptive analysis, and multivariable logistic regression model were performed, by gender. Results: Of 1,41,215 hypertensive individuals analyzed, 34.7% of men and 53.6% of women were aware of being hypertensive. The control among those aware was 67.1% in men and 74.6% in women. The awareness varied among states ranging from 29.6% in Chhattisgarh to 75.6% in Tamil Nadu. The multivariable logistic regression model explained the awareness of hypertension in males increased with age (odds ratios [OR]: 0.226 for 95% confidence interval [CI]: 0.139-0.366 for 25-29 years of age increased to 0.599 for 95% CI: 0.48-0.74 for 40-44 years of age), education (OR of 0.66 for 95% CI: 0.51-0.85 for primary increased to 0.69 for 95% CI: 0.54-0.89 for secondary school level), and wealth status (OR of 0.407 for 95% CI: 0.309-0.535 for poor wealth quintile increased to 1.030 for 95% CI: 0.863-1.230 for the richest wealth quintile). For women, the awareness increased with age (OR of 0.306 for 95% CI: 0.119- 0.791 for the age of 20-24 years increased to 0.736 for 95% CI: 0.570-0.951 for the age of 45-49 years) and wealth status (OR of 0.28 for 95% CI: 0.18-0.44 for poor wealth quintile increased to 1.262 for 95% CI: 0.859-1.855 for the richest wealth quintile). Conclusion: Improving access to hypertension screening and awareness especially among men, with lower wealth and younger age is needed.

FLED-Block: Federated Learning Ensembled Deep Learning Blockchain Model for COVID-19 Prediction.

With the SARS-CoV-2's exponential growth, intelligent and constructive practice is required to diagnose the COVID-19. The rapid spread of the virus and the shortage of reliable testing models are considered major issues in detecting COVID-19. This problem remains the peak burden for clinicians. With the advent of artificial intelligence (AI) in image processing, the burden of diagnosing the COVID-19 cases has been reduced to acceptable thresholds. But traditional AI techniques often require centralized data storage and training for the predictive model development which increases the computational complexity. The real-world challenge is to exchange data globally across hospitals while also taking into account of the organizations' privacy concerns. Collaborative model development and privacy protection are critical considerations while training a global deep learning model. To address these challenges, this paper proposes a novel framework based on blockchain and the federated learning model. The federated learning model takes care of reduced complexity, and blockchain helps in distributed data with privacy maintained. More precisely, the proposed federated learning ensembled deep five learning blockchain model (FLED-Block) framework collects the data from the different medical healthcare centers, develops the model with the hybrid capsule learning network, and performs the prediction accurately, while preserving the privacy and shares among authorized persons. Extensive experimentation has been carried out using the lung CT images and compared the performance of the proposed model with the existing VGG-16 and 19, Alexnets, Resnets-50 and 100, Inception V3, Densenets-121, 119, and 150, Mobilenets, SegCaps in terms of accuracy (98.2%), precision (97.3%), recall (96.5%), specificity (33.5%), and F1-score (97%) in predicting the COVID-19 with effectively preserving the privacy of the data among the heterogeneous users.

Health-related quality of life of multidrug-resistant tuberculosis patients: A study of eastern Uttar Pradesh, India.

INTRODUCTION: Much attention has been given to the microbiological aspect, drug treatment, and clinical indicators of MDR-TB, but patients' QOL has remained a neglected area. In this study, we aimed to find the quality of MDRTB on various quality of life domains during the initiation of the MDR Treatment regimen. MATERIALS & METHODS: A cross-sectional study was conducted over a period of 6 months at the Drug-Resistance Tuberculosis Management Centre (DR-TB Centre), of a tertiary care centre in the eastern Uttar pradesh, India. Patients with age >18 years diagnosed with MDR-TB (Multidrug resistance TB) were included in the study. The WHO QOL-BREF scale was used to assess the health-related quality of life of patients. Data were analyzed using SPSS version 21. The institutional ethical review committee approved the study, and consent was taken before the participation of patients. RESULTS: A total of 157 patients were included in the study & 45.85% were dissatisfied with their condition. Social domain of WHO QOL-BREF is having the lowest mean score (28.51 ± 15.4) while psychological has high mean values (39.92 ± 6.91). There was a significant difference in the physical health domain with respect to age (p-value 0.001). Similar differences have been seen in the psychological domain regarding patient sex (p-value 0.001), smoking and alcohol within the social domain, and loss of income in the environmental domain. CONCLUSION: The mean value of different domains of WHO QOL-BREF is low in MDR-TB patients, with social relation domain being the most affected.

Micronutrient's deficiency in India: a systematic review and meta-analysis.

India is coming to grips with a stage of nutrition transition. According to the Food Safety and Standards Authority of India (FSSAI), preventable micronutrient deficiency is arising public health precedence in India. However, the foremost public health concern is the lack of national prevalence data. The present study was carried out to estimate the pooled age-wise prevalence of six preventable micronutrient deficiencies (vitamin A, vitamin B12, vitamin D, iron, iodine and folic acid) in India. A systematic review was carried out on PubMed and Global Index Medicus databases using the Boolean search strategy. Statistical analyses were done using R software, version 3.6. 2. PRISMA guidelines were strictly adhered to during the review. A preliminary literature search yielded 4302 articles; however, 270 original research articles were found eligible to be included in quantitative synthesis. The estimated overall prevalence was 17 % [95 % confidence interval (CI) 0⋅07, 0⋅26] for iodine deficiency, 37 % (95 % CI 0⋅27, 0⋅46) for folic acid deficiency, 54 % (95 % CI 0⋅49, 0⋅59) for iron deficiency, 53 % (95 % CI 0⋅41, 0⋅64) for vitamin B12 deficiency, 19 % (95 % CI 0⋅09, 0⋅29) for vitamin A deficiency and 61 % (95 % CI 0⋅07, 0⋅26) for vitamin D with high heterogeneity. We classified the population into infants (0-5 years), adolescents (<18 years), adults (>18 years) and pregnant women. Iron deficiency was most prevalent (61 %) in pregnant women. The results of the present study reinforce the data on micronutrient deficiency in India and warrant the immediate need for further active public health interventions to address these deficiencies. The study is registered with PROSPERO (CRD42020205043).

Structural, vibrational and optical studies on semiorganic crystals of boric acid potassium acetate.

A semiorganic crystal of Boricacid potassium acetate has been grown by low temperature solution growth technique at room temperature using deionized water as a solvent. The crystalline nature of the compound was confirmed by the sharp and well defined peaks observed from the powder X-ray diffraction pattern. By single crystal X-ray diffraction method, the structure of the grown crystal has been studied. The Boric acid Potassium Acetate (BAPA) crystal has good optical transmittance in the entire UV visible region. FT-IR and FT-Raman spectral studies were performed to identify the vibrations of functional groups. The mechanical strength of the grown crystal was determined by Vicker's micro hardness test. Photoluminescence study was carried out on the crystal. The SHG study represents the nonlinear optical efficiency of the crystal.

Presentation and Outcomes After Medical and Surgical Treatment Versus Medical Treatment Alone of Spontaneous Infectious Spondylodiscitis: A Systematic Literature Review and Meta-Analysis.

STUDY DESIGN: Systematic literature review. OBJECTIVES: The aims of this study were to (1) describe the clinical features, disabilities, and incidence of neurologic deficits of pyogenic spondylodiscitis prior to treatment and (2) compare the functional outcomes between patients who underwent medical treatment alone or in combination with surgery for pyogenic spondylodiscitis. METHODS: A systematic literature review was performed using PubMed according to PRISMA guidelines. No year restriction was put in place. Statistical analysis of pooled data, when documented in the original report (ie, number of patients with desired variable and number of patients evaluated), was conducted to determine the most common presenting symptoms, incidence of pre- and postoperative neurologic deficits, associated comorbidities, infectious pathogens, approach for surgery when performed, and duration of hospitalization. Outcomes data, including return to work status, resolution of back pain, and functional recovery were also pooled among all studies and surgery-specific studies alone. Meta-analysis of studies with subgroup analysis of pain-free outcome in surgical and medical patients was performed. RESULTS: Fifty of 1286 studies were included, comprising 4173 patients undergoing either medical treatment alone or in combination with surgery. Back pain was the most common presenting symptom, reported in 91% of patients. Neurologic deficit was noted in 31% of patients. Staphylococcus aureus was the most commonly reported pathogen, seen in 35% of reported cases. Decompression and fusion was the most commonly reported surgical procedure, performed in 80% of the surgically treated patients. Combined anterior-posterior procedures and staged surgeries were performed in 33% and 26% of surgeries, respectively. The meta-analysis comparing visual analog scale score at follow-up was superior among patients receiving surgery over medical treatment alone (mean difference -0.61, CI -0.90 to -0.25), while meta-analysis comparing freedom from pain in patients receiving medical treatment alone versus combined medical and surgical treatment demonstrated superior pain-free outcomes among surgical series (odds ratio 5.35, CI 2.27-12.60, P < .001), but was subject to heterogeneity among studies (I 2 = 56%, P = .13). Among all patients, freedom from pain was achieved in 79% of patients, and an excellent outcome was achieved in 73% of patients. CONCLUSION: Medical management remains first-line treatment of infectious pyogenic spondylodiscitis. Surgery may be indicated for progressive pain, persistent infection on imaging, deformity or neurologic deficits. If surgery is required, reported literature shows potential for significant pain reduction, improved neurologic function and a high number of patients returning to a normal functional/work status.

Complications of surgical intervention in adult lumbar scoliosis.

If nonoperative measures are unsuccessful in managing the pain and disability of adult spinal deformities, surgical correction may provide the potential for significant improvement in a patient's quality of life. However, these procedures have a relatively high risk of complications. Identifying patients that may benefit from surgical intervention requires a thorough understanding of potential complications and managing the risks of any individual patient. Complications do not necessarily result in poor outcomes, and good outcomes are not always complication free. Higher risk patients potentially have more to gain, even if they experience complications. With the rapidly expanding senior population and expanded capabilities to manage high-risk patients, it is helpful to consider the lessons provided by ever expanding databases of outcome measures to refine the surgical decision-making process.

Surgical considerations for major deformity correction spine surgery.

Spinal deformity is defined as abnormality in alignment, formation, or curvature of one or more segments of the spine. Its characteristic clinical presentation and radiographic appearance differ according to patient age and the underlying cause. The most common deformity in the pediatric population is adolescent idiopathic scoliosis, whereas in adults many patients present with de novo deformity secondary to degenerative disease. Although the specific goals differ between patients, the broad aims include restoration of regional and global alignment, decompression of neural elements as necessary, and establishment of a solid fusion. Surgeons perform deformity correction by various approaches and techniques to achieve the desired correction while minimizing perioperative risk.

Molecular vibrational investigation [FT-IR, FT-Raman, UV-Visible and NMR] on Bis(thiourea) Nickel chloride using HF and DFT calculations.

In the present research work, the FT-IR, FT-Raman spectra of the Bis(thiourea) Nickel chloride (BTNC) were recorded and analyzed. The observed fundamental frequencies in finger print and functional group regions were assigned according to their uniqueness region. The computational calculations were carried out by HF and DFT (B3LYP and B3PW91) methods with 6-31++G(d,p) and 6-311++G(d,p) basis sets and the corresponding results were tabulated. The present organo-metallic compound was made up of covalent and coordination covalent bonds. The modified vibrational pattern of the complex molecule associated with ligand group was analyzed. Furthermore, the (13)C NMR and (1)H NMR spectral data were calculated by using the gauge independent atomic orbital (GIAO) method with B3LYP/6-311++G(d,p) basis set and their spectra were simulated and the chemical shifts linked to TMS were compared. A investigation on the electronic and optical properties; absorption wavelengths, excitation energy, dipole moment and frontier molecular orbital energies were carried out. The kubo gap of the present compound was calculated related to HOMO and LUMO energies which confirm the occurring of charge transformation between the base and ligand. Besides frontier molecular orbitals (FMO), molecular electrostatic potential (MEP) was performed. The NLO properties related to Polarizability and hyperpolarizability based on the finite-field approach were also discussed.

Driving simulator validation of driver behavior with limited safe vantage points for data collection in work zones.

INTRODUCTION: This study is aimed at validating a driving simulator (DS) for the study of driver behavior in work zones. A validation study requires field data collection. For studies conducted in highway work zones, the availability of safe vantage points for data collection at critical locations can be a significant challenge. A validation framework is therefore proposed in this paper, demonstrated using a fixed-based DS that addresses the issue by using a global positioning system (GPS). METHODS: The validation of the DS was conducted using objective and subjective evaluations. The objective validation was divided into qualitative and quantitative evaluations. The DS was validated by comparing the results of simulation with the field data, which were collected using a GPS along the highway and video recordings at specific locations in a work zone. The constructed work zone scenario in the DS was subjectively evaluated with 46 participants. RESULTS: The objective evaluation established the absolute and relative validity of the DS. The mean speeds from the DS data showed excellent agreement with the field data. The subjective evaluation indicated realistic driving experience by the participants. PRACTICAL APPLICATIONS: The use of GPS showed that continuous data collected along the highway can overcome the challenges of unavailability of safe vantage points especially at critical locations. Further, a validated DS can be used for examining driver behavior in complex situations by replicating realistic scenarios.

Alcohol use disorders (AUD) among tuberculosis patients: a study from Chennai, South India.

BACKGROUND: Alcohol Use Disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC), Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India. METHODOLOGY: This is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption. RESULTS: Out of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of 8. Age (>35 years), education (less educated), income (

Osteoid osteomas: intraoperative bone scan-assisted resection. Clinical article.

OBJECT: Osteoid osteomas (OOs) are benign lesions of the spine, but can cause significant pain and spinal deformity in the pediatric population. They are often surgically elusive, and may require multiple surgical procedures to ensure complete resection. Nuclear medicine intraoperative bone scans (IOBSs) are highly sensitive for lesion localization and verification of complete surgical extirpation. METHODS: A retrospective review of 20 consecutive patients who had undergone resection of a spinal OO at the authors' institution was undertaken. In all cases, IOBSs were used for lesion localization and verification of resection. Postoperative imaging and clinical follow-up were obtained. RESULTS: The average length of follow-up was 56 months, with a range of 8-156 months. Five patients had undergone a total of 12 unsuccessful prior procedures for resection at other institutions where IOBSs were not used. In these patients, complete resection was accomplished with the use of IOBSs at the authors' institution. Of the 15 patients who presented to this institution with a newly diagnosed OO and who underwent IOBS-assisted resection, 14 had complete resection without recurrence. One patient, however, was found to have a discrete recurrence adjacent to the initial resection bed at the time of follow-up. CONCLUSIONS: Osteoid osteomas are benign lesions of the spine, and complete resection is curative. If resection is incomplete, then recurrence is likely. The IOBS modality is highly sensitive for detecting OO and for guiding complete resection. The IOBS modality should be considered as a first-line surgical adjunct in cases of suspected OO.

Neural network committees for finger joint angle estimation from surface EMG signals.

BACKGROUND: In virtual reality (VR) systems, the user's finger and hand positions are sensed and used to control the virtual environments. Direct biocontrol of VR environments using surface electromyography (SEMG) signals may be more synergistic and unconstraining to the user. The purpose of the present investigation was to develop a technique to predict the finger joint angle from the surface EMG measurements of the extensor muscle using neural network models. METHODOLOGY: SEMG together with the actual joint angle measurements were obtained while the subject was performing flexion-extension rotation of the index finger at three speeds. Several neural networks were trained to predict the joint angle from the parameters extracted from the SEMG signals. The best networks were selected to form six committees. The neural network committees were evaluated using data from new subjects. RESULTS: There was hysteresis in the measured SMEG signals during the flexion-extension cycle. However, neural network committees were able to predict the joint angle with reasonable accuracy. RMS errors ranged from 0.085 +/- 0.036 for fast speed finger-extension to 0.147 +/- 0.026 for slow speed finger extension, and from 0.098 +/- 0.023 for the fast speed finger flexion to 0.163 +/- 0.054 for slow speed finger flexion. CONCLUSION: Although hysteresis was observed in the measured SEMG signals, the committees of neural networks were able to predict the finger joint angle from SEMG signals.

Synthesis and antibacterial property of quinolines with potent DNA gyrase activity.

Synthesis of a series of novel tetrahydroquinoline annulated heterocycles has been accomplished by intramolecular imino and bisimino Diels-Alder reaction. These compounds were evaluated for their antibacterial activity. All the synthetic compounds, exhibited good antibacterial activity against microorganisms of which one of them 7 was found to be as active as the antibiotic ciplofloxacin and is found to have MIC value of 2.5 mg/mL against Escherichia coli.

Antimutagenic activity of plumbagin in Ames Salmonella typhimurium test.

This paper reports the antimutagenic activity of plumbagin (5-hydroxy-2-methyl-1, 4-naphthoquinone) against certain known chemical mutagens in a standard mutagenicity test system of Ames using S. typhimurium strains. Plumbagin by itself did not show any mutagenic effect, whereas it reduced significantly the mutagenic effect of 4-nitrophenylene diammine, phenyl hydrazine and sodium azide in test strains of S. typhimurium, suggesting that plumbagin possessed antimutagenic activity.

Effects of plumbagin on antibiotic resistance in bacteria.

Plumbagin, a compound derived from the roots of Plumbago zeylanica (Chitramool) was studied for its effect on the development of antibiotic resistance using antibiotic sensitive strains of Escherichia coli and Staphylococcus aureus. A delayed growth was seen when these organisms were inoculated into the antibiotic (streptomycin/rifampicin) medium, due to development of resistance in some of the cells. However, the growth was completely prevented when the bacteria were grown in the medium containing antibiotic and plumbagin together, and this was attributed to prevention of development of antibiotic resistant cells.