Maternal Health Status in Tribal India: A 5-Year Intervention Program and its Outcome.

INTRODUCTION: There is poor penetration of evidence-based maternal health care provided under national health programs in resource-poor underserved regions. A well-planned locally acceptable community-driven comprehensive health promotion strategy and quality health care delivery mechanism is necessary to improve the situation. OBJECTIVE: The main objective was to find the gaps in the existing system and promote health literacy and health-seeking behavior. METHODOLOGY: 80,000 tribal population living in isolated conflict zone of Bastar district was covered for 5 years between 2012 and 2017. An integrated health-care plan was developed with community leaders, panchayat, and the local government to promote and provide quality evidence-based maternal health care. Available resources were mobilized and health technologies introduced. RESULTS: Regular home visits, point of care diagnostics, identification of high-risk mothers and their timely referral, and behavioral change communication increased the trust of the community. It resulted in higher demand for evidence-based health interventions. The adolescent pregnancy rate (<19 years) reduced to 6.8% (2016) from 13.5% (2012). Hemoglobin level >9 g% (third trimester) improved. Supervised births and high-risk referrals increased from 19.5% (2014) to 58% (2017) and 8.5% (2014) to 13.1% (2017), respectively. Although significant improvement was noted, key indicators continued to remain below rural Bastar (National Family Health Survey-4). CONCLUSION: Promotion of existing good practices, behavior change, health technologies, and evidence-based emergency care improved the maternal health status of the secluded and underserved tribal community, but persistent effort is needed to enable women access the quality maternal health services provided under National Health Mission.

Backtracking dynamics of RNA polymerase: pausing and error correction.

Transcription by RNA polymerases is frequently interrupted by pauses. One mechanism of such pauses is backtracking, where the RNA polymerase translocates backward with respect to both the DNA template and the RNA transcript, without shortening the transcript. Backtracked RNA polymerases move in a diffusive fashion and can return to active transcription either by diffusive return to the position where backtracking was initiated or by cleaving the transcript. The latter process also provides a mechanism for proofreading. Here we present some exact results for a kinetic model of backtracking and analyse its impact on the speed and the accuracy of transcription. We show that proofreading through backtracking is different from the classical (Hopfield-Ninio) scheme of kinetic proofreading. Our analysis also suggests that, in addition to contributing to the accuracy of transcription, backtracking may have a second effect: it attenuates the slow down of transcription that arises as a side effect of discriminating between correct and incorrect nucleotides based on the stepping rates.

Quantum work relations under trial Hamiltonians.

The universal quantum work relation connects a functional of an arbitrary observable averaged over the forward process to the free-energy difference and another functional averaged over the time-reversed process. Here, we ask the question if the system is driven out of equilibrium by a different Hamiltonian rather than the original one during the forward process and similarly during the reversed process then how accurate is the quantum work relation. We present an inequality that must be satisfied when the system is driven out by such a trial Hamiltonian. This also answers the issue of accuracy of the Jarzynski relation with a trial Hamiltonian. We have shown that the correction term can be expressed as the averages of the difference operator between the accurate and trial Hamiltonians. This leads to a generalized version of the Bogoliubov inequality for the free-energy differences.

Charged particle in a magnetic field: Jarzynski equality.

We describe some solvable models which illustrate the Jarzynski theorem and related fluctuation theorems. We consider a charged particle in the presence of a magnetic field in a two-dimensional harmonic well. In the first case the center of the harmonic potential is translated with a uniform velocity, while in the other case the particle is subjected to an ac force. We show that the Jarzynski identity complements the Bohr-van Leeuwen theorem on the absence of diamagnetism in an equilibrium classical system.