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India has the second largest number of people with type 2 diabetes (T2D) globally. Epidemiological evidence indicates that consumption of white rice is positively associated with T2D risk, while intake of brown rice is inversely associated. Thus, we explored the effect of substituting brown rice for white rice on T2D risk factors among adults in urban South India. A total of 166 overweight (BMI ≥ 23 kg/m2) adults aged 25–65 years were enrolled in a randomised cross-over trial in Chennai, India. Interventions were a parboiled brown rice or white rice regimen providing two ad libitum meals/d, 6 d/week for 3 months with a 2-week washout period. Primary outcomes were blood glucose, insulin, glycosylated Hb (HbA1c), insulin resistance (homeostasis model assessment of insulin resistance) and lipids. High-sensitivity C-reactive protein (hs-CRP) was a secondary outcome. We did not observe significant between-group differences for primary outcomes among all participants. However, a significant reduction in HbA1c was observed in the brown rice group among participants with the metabolic syndrome (−0·18 (se 0·08) %) relative to those without the metabolic syndrome (0·05 (se 0·05) %) (P-for-heterogeneity = 0·02). Improvements in HbA1c, total and LDL-cholesterol were observed in the brown rice group among participants with a BMI ≥ 25 kg/m2 compared with those with a BMI < 25 kg/m2 (P-for-heterogeneity < 0·05). We observed a smaller increase in hs-CRP in the brown (0·03 (sd 2·12) mg/l) compared with white rice group (0·63 (sd 2·35) mg/l) (P = 0·04). In conclusion, substituting brown rice for white rice showed a potential benefit on HbA1c among participants with the metabolic syndrome and an elevated BMI. A small benefit on inflammation was also observed.
There are few data on excess direct and indirect costs of diabetes in India and limited data on rural costs of diabetes. We aimed to further explore these aspects of diabetes burdens using a clinic-based, comparative cost-of-illness study.
Persons with diabetes (n = 606) were recruited from government, private, and rural clinics and compared to persons without diabetes matched for age, sex, and socioeconomic status (n = 356). We used interviewer-administered questionnaires to estimate direct costs (outpatient, inpatient, medication, laboratory, and procedures) and indirect costs [absence from (absenteeism) or low productivity at (presenteeism) work]. Excess costs were calculated as the difference between costs reported by persons with and without diabetes and compared across settings. Regression analyses were used to separately identify factors associated with total direct and indirect costs.
Annual excess direct costs were highest amongst private clinic attendees (INR 19 552, US$425) and lowest amongst government clinic attendees (INR 1204, US$26.17). Private clinic attendees had the lowest excess absenteeism (2.36 work days/year) and highest presenteeism (0.06 work days/year) due to diabetes. Government clinic attendees reported the highest absenteeism (7.48 work days/year) and lowest presenteeism (−0.31 work days/year). Ten additional years of diabetes duration was associated with 11% higher direct costs (p < 0.001). Older age (p = 0.02) and longer duration of diabetes (p < 0.001) were associated with higher total lost work days.
Excess health expenditures and lost productivity amongst individuals with diabetes are substantial and different across care settings. Innovative solutions are needed to cope with diabetes and its associated cost burdens in India.
The Evolutionary Map of the Universe (EMU) is a proposed radio continuum survey
of the Southern Hemisphere up to declination + 30°, with the Australian
Square Kilometre Array Pathfinder (ASKAP). EMU will use an automated source
identification and measurement approach that is demonstrably optimal, to
maximise the reliability and robustness of the resulting radio source
catalogues. As a step toward this goal we conducted a “Data
Challenge” to test a variety of source finders on simulated images. The
aim is to quantify the accuracy and limitations of existing automated source
finding and measurement approaches. The Challenge initiators also tested the
current ASKAPsoft source-finding tool to establish how it could benefit from
incorporating successful features of the other tools. As expected, most finders
show completeness around 100% at ≈ 10σ dropping to about 10% by
≈ 5σ. Reliability is typically close to 100% at ≈
10σ, with performance to lower sensitivities varying between finders. All
finders show the expected trade-off, where a high completeness at low
signal-to-noise gives a corresponding reduction in reliability, and vice versa.
We conclude with a series of recommendations for improving the performance of
the ASKAPsoft source-finding tool.
Silicon nanoparticles are synthesized by very high frequency Plasma Enhanced Chemical Vapor Deposition (vhf-PECVD) in the gas phase. Pulsed plasmas are used to obtain particles with a narrow size distribution. The role of plasma OFF times is studied to tailor the size of the silicon nanoparticles. Various plasma OFF times are chosen, both longer- and shorter -than the residence time of the gases in the discharge. Time resolved optical emission spectroscopy (TROES) studies provide additional information about the growth precursor dynamics during plasma modulation. The size and the size distribution studies of the particles are done with transmission electron microscopy (TEM). These studies reveal that a plasma OFF time longer than the residence time is favorable for the formation of quantum sized silicon particles.
Physical inactivity and low birth weight (LBW) may lead to an increased risk for developing type 2 diabetes. The extent to which LBW individuals may benefit from physical exercise training when compared with those with normal birth weight (NBW) controls is uncertain. We assessed the impact of an outdoor exercise intervention on body composition, insulin secretion and action in young men born with LBW and NBW in rural India. A total of 61 LBW and 56 NBW healthy young men were recruited into the study. The individuals were instructed to perform outdoor bicycle exercise training for 45 min every day. Fasting blood samples, intravenous glucose tolerance tests and bioimpedance body composition assessment were carried out. Physical activity was measured using combined accelerometry and heart rate monitoring during the first and the last week of the intervention. Following the exercise intervention, the LBW group displayed an increase in physical fitness [55.0 ml (O2)/kg min (52.0−58.0)−57.5 ml (O2)/kg min (54.4−60.5)] level and total fat-free mass [10.9% (8.0−13.4)−11.4% (8.0−14.6)], as well as a corresponding decline in the ratio of total fat mass/fat-free mass. In contrast, an increase in total fat percentage as well as total fat mass was observed in the NBW group. After intervention, fasting plasma insulin levels, homoeostasis model assessments (HOMA) of insulin resistance (HOMA-IR) and insulin secretion (HOMA-IS), improved to the same extent in both the groups. In summary, young men born with LBW in rural India benefit metabolically from exercise training to an extent comparable with NBW controls.
We review recent applications of wavefunction engineering to the design of antimonide quantum heterostructures with favorable properties for infrared devices. Examples include electro-optical and all-optical modulators based on Г-L intervalley transfer, type-II quantum well lasers with enhanced gain per injected carrier, and type-II interband cascade lasers predicted to combine low thresholds and high output powers.
Estimating robot performance in human robot teams is a vital problem in human robot interaction community. In a previous work, we presented extended neglect tolerance model for estimation of robot performance, where the human operator switches control between robots sequentially based on acceptable performance levels, taking into account any false alarms in human robot interactions. Task complexity is a key parameter that directly impacts the robot performance as well as the false alarms occurrences. In this paper, we validate the extended neglect tolerance model for two robot tasks of varying complexity levels. We also present the impact of task complexity on robot performance estimations and false alarms demands. Experiments were performed with real and virtual humanoid soccer robots across tele-operated and semi-autonomous modes of autonomy. Measured false alarm demand and robot performances were largely consistent with the extended neglect tolerance model predictions for both real and virtual robot experiments. Experiments also showed that the task complexity is directly proportional to false alarm demands and inversely proportional to robot performance.
In 1978, 22 staff members of the National Institute of Virology, Pune, India, were given two doses of human diploid cell antirabies vaccine (HDCV) for primary pre-exposure prophylactic immunization; the interval between the two doses being approximately 4 weeks. Eighteen of these 22 vaccinees were given a booster dose 1 year later. All 18 vaccinees developed protective levels of antibody; most of them had antibody levels exceeding 10 IU/ml.
In 1984, 5 years after the booster dose, 11 (79·0%) of 14 vaccinees tested still possessed neutralizing antibody levels ranging from 0·5 IU/ml to 10 IU/ml. Fourteen days after the administration of a booster dose, the antibody levels ranged from 10 to ≥ 100 IU/ml for all except one vaccinee (5·2 IU/ml). These findings demonstrate that the majority of vaccinees retained detectable neutralizing antibody after pre-exposure prophylaxis for as long as 5 years and that a single booster dose thereafter evoked a good antibody response.
Molecular markers have been used to study genetic diversity within a set of Lablabpurpureus accessions collected from the southern states of India. Amplified fragment length polymorphism (AFLP) molecular marker studies using a total of 78 L. purpureus accessions with nine primer combinations showed there was very little genetic diversity within the L. purpureus accessions from the southern Indian germplasm collection as compared to a set of 15 accessions from other international germplasm collections that included African accessions. The set of 15 were selected from a random amplified length polymorphism (RAPD) marker study and chosen on the basis of widest genetic distance. Further molecular analysis with polymerase chain reaction (PCR) markers from 97 expressed sequence tag (EST) and gene-specific primer pairs, designed from a range of legume sequences, concurred with the AFLP analyses. Both of these approaches provide a wealth of markers for diversity and mapping studies. The 97 sequence-specific primer pairs tested in L. purpureus resulted in 70% amplification success, with 44% of primer pairs amplifying single bands and 10% double bands. Markers generated from these EST and genomic sequences provide useful cross-reference to comparative legume genomics that will potentially have long-term benefit to legume plant breeding.
The aim of this study was to ascertain whether international glycaemic index (GI) values, predominantly developed using peoples living in Europe, North America or Australia, are applicable to Asian Indians resident in their own country. Thirty-four Caucasian subjects were recruited in Oxford, UK and thirteen Asian Indian subjects in Chennai, India. Two types of sweet biscuits and three breakfast cereals were tested for glycaemic response in each group. Subjects were served equivalent available carbohydrate amounts (50 g) of test foods and a reference food (glucose), on separate occasions. Capillary blood glucose was measured from finger-prick samples in fasted subjects ( − 5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min after starting to eat. For each test food, the incremental area under the curve (IAUC) and GI values were determined. Although the glycaemic response to the reference food was higher in Asian Indian subjects compared with UK Caucasian subjects (IAUC 219 mmol/min per litre v. 157 mmol/min per litre, respectively; P < 0·01), there was no significant difference in GI values of the five test foods between the two groups. This is the first study known to the authors to examine the role of ethnicity on GI when the subjects are resident in their own countries. The findings from this study have important implications for the use of the GI concept worldwide and support the application of international values to different ethnic groups. The higher glycaemic response to all foods in Asian Indians may represent another mechanism for increased diabetes susceptibility among Asian Indians.
Because of its ability to induce contact dermatitis, the establishment and spread of poison ivy is recognized as a significant public health concern. In the current study, we quantified potential changes in the biomass and urushiol content of poison ivy as a function of incremental changes in global atmospheric carbon dioxide concentration (CO2). We also examined the rate of new leaf development following leaf removal to simulate responses to herbivory as functions of both CO2 and plant size. The experimental CO2 values (300, 400, 500. and 600 µmol mol−1) corresponded approximately to the concentration that existed during the middle of the 20th century, the current concentration and near and long-term projections for this century (2050 and 2090), respectively. Over 250 d, increasing CO2 resulted in significant increases in leaf area, leaf and stem weight, and rhizome length relative to the 300 µmol mol−1 baseline with the greatest relative increase occurring from 300 to 400 µmol mol−1. There was a nonsignificant (P = 0.18) increase in urushiol concentration in response to CO2; however, because of the stimulatory effect of CO2 on leaf biomass, the amount of urushiol produced per plant increased significantly for all CO2 above the 300 µmol mol−1 baseline. Significant increases in the rate of leaf development following leaf removal were also observed with increasing CO2. Overall, these data confirm earlier, field-based reports on the CO2 sensitivity of poison ivy but emphasize its ability to respond to even small (∼ 100 µmol mol−1) changes in CO2 above the mid-20th century carbon dioxide baseline and suggest that its rate of spread, its ability to recover from herbivory, and its production of urushiol, may be enhanced in a future, higher CO2 environment.
Functional endoscopic sinus surgery (FESS) is a widely practiced technique in the UK. This procedure has variable complication rates and can have some serious consequences. We present a case of surgical emphysema of the neck, face and the pre-vertebral space following FESS. Emphysema of the face and neck has been previously reported. However, to our knowledge, emphysema of the pre-vertebral space following FESS has not been documented. Pre-vertebral emphysema following FESS is an unusual and potentially serious complication.
We report a rare case of an unusual impacted foreign body (titanium mesh stent) in the hypopharynx and upper oesophagus of a 66-year-old gentleman. He was a known patient with carcinoma of the mid-oesophagus admitted under the gastroenterologists for dilatation of the carcinomatous stricture with a stent. During the procedure the titanium mesh spring coil got displaced and was impacted in the retropharyngeal space, submucosally in the hypopharynx and upper oesophagus. He was referred to us for surgical removal of the stent, which he underwent successfully. We believe this to be the first case of such an unusual foreign body to be reported in the literature.
In the first study to systematically examine postnatal depression in fathers, we examined depression in 200 postnatal couples, using a two-stage design. The prevalence of depression ascertained by the 13-item Edinburgh Postnatal Depression Scale (EPDS), using a cut-off score for ‘caseness’ of 13 or more in an unselected postnatal sample, was 27.5% in mothers at six weeks postpartum, 25.7% in mothers at six months postpartum, 9.0% in fathers at six weeks postpartum, and 5.4% in fathers at six months postpartum. The prevalence did not differ significantly in either mothers or fathers from a control group of parents with children between three and five years of age. As expected, mothers had a significantly higher prevalence of psychiatric ‘caseness’ at both six weeks and six months postpartum than fathers. Fathers were significantly more likely to be cases if their partners were also cases. The hypothesis that different aetiological factors would be important in brief and persistent disorders in mothers was upheld.
The mean annual rates of hospital admission for deliberate self-poisoning were calculated for Caucasian and Asian 12–15–year-olds between 1982 and 1990 as 2.31 and 2.47 per 1000 respectively. There was an excess of girls in each group.
Compliance with medication regimes is fundamental to successful treatment and hence familiarity with factors influencing the level of patient compliance is essential. In relation to the psychogeriatric population poor compliance is a major and worrying problem largely neglected by researchers.
Mental health problems in primary care settings have received wider attention in recent years (Wilkinson, 1985). In India, the National Mental Health Programme (NMHP) was formulated with the purpose of promoting mental health care through primary health care (National Mental Health Programme, 1982). As part of the implementation of NMHP, training programmes for medical officers and health workers have been initiated in a number of centres in the country (National Mental Health Programme for India, Progress Report, 1988). At the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, a monthly training programme for doctors and health workers of primary health centres has been carried out since 1982. In order to evaluate the gain in knowledge and clinical skills, a multiple-choice questionnaire and case vignettes have been standardised (Sriram et al, in press). The doctors are also evaluated through a structured clinical examination which is carried out on the last training day. The focus of the present report is to evaluate the clinical skills of medical officers using the structured clinical examination.
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