Experienced Love: An Empirical Account.

This article presents new evidence on the prevalence, dynamics, and hedonic correlates of experienced love from data describing the emotion, well-being, and time use of a diverse sample of 3,867 U.S. adults every half hour for 10 days (N = 1.12 million) supplemented by a hedonic snapshot of an additional 7,255 adults. The findings allude to the seemingly functional and adaptive nature of love and to similarities across binary gender-men and women reported comparable degrees of (passionate) partner love overall, elevated partner love after prolonged same-day separations, substantially elevated well-being in love's presence, and reduced (but not extinguished) partner love in mature marital cohorts. The gender differences that were found-women reported more child love than men, and men exhibited a less pronounced reduction in partner love across cohorts-are also consistent with functional accounts of love that recognize the varying role of men and women in the formation and sustenance of relationships.

Assessment of Home-Based Care for Young Child (HBYC) Program in Aspirational Districts of Madhya Pradesh, India: A Cross-Sectional Study.

Context: In 2018, Government of India initiated Home-Based Care for Young Child (HBYC) program having five quarterly structured home visits for children age 3 to 15 months to promote early childhood development. Assess knowledge and practices of Accredited Social Health Activist (ASHAs), other health functionaries, and mothers related to HBYC. Cross-sectional evaluation design with ASHAs, AWWs, ANMs, ASHA, and mothers of 3 to 15 month's children as participants. Material and Methods: Knowledge and practices of 801 ASHAs, 200 other health functionaries, and 787 mothers were assessed on exclusive breastfeeding, complementary feeding, hand washing, iron folic acid (IFA) and oral rehydration solution (ORS) supplementation, danger referral signs in eight aspirational districts of Madhya Pradesh. Results: 88% ASHAs had correct knowledge on ORS, 85% on complementary feeding, 85% on adequacy of IFA, and 47% on danger signs which required child referral. Similarly, 85% of mothers had knowledge on exclusive breastfeeding, 40% mothers knew about complementary feeding, and only 18% knew correct ORS preparation. Statistically significant association was observed between ASHAs home visits and availability of ORS with mothers and their knowledge on correct Initiation of IFA (p < 0.001). Conclusion: Findings of study confirmed majority of health functionaries were aware about roles, responsibilities, and key tasks under HBYC. However, there observed a gap in knowledge transfer by health functionaries and thus inadequate translation of knowledge into practices among mothers on HBYC. This necessitates the need of appropriate actions from health system strengthening to capacity building to accelerate uptake of HBYC program.

Comparative Snake Venom Analysis for Facilitating Wildlife Forensics: A Pilot Study.

Confirm and authentic identification of species is required for the implementation of wildlife laws in cases of illegal trafficking of snake venoms. Illegally trafficked snake venom might be misidentified with other drugs of abuse, and sometimes, the species of venom-yielding snake cannot be verified. Snake venoms from medically important snake species, Naja naja and Daboia russelii, were procured from Irula Snake Catcher's Society, Tamil Nadu, India. Comparative analyses of both venoms were carried out using SDS-PAGE, LC-MS/MS, ICP-MS, and mtDNA analysis. The protein concentration of Naja naja and Daboia russelii venoms was 76.1% and 83.9%, respectively. SDS analysis showed a distinct banding pattern of both venoms. LC-MS/MS results showed proteins and toxins from 12 to 14 protein families in Naja naja and Daboia russelii venoms. Elemental analysis using ICP-MS showed a different profile of some elements in both venoms. mtDNA analysis of venoms using universal primers against Cyt b gene showed homology with sequence of Naja naja and Daboia russelii genes. The study proposed a template of various conventional and advanced molecular and instrumental techniques with their pros and cons. The template can be used by forensic science laboratories for detection, screening, and confirmatory analysis of suspected venoms of snakes. Clubbing of various techniques can be used to confirm the identification of species of snake from which the alleged venom was milked. The results can be helpful in framing charge-sheets against accused of illegal venom trafficking and can also be used to verify the purity and quality of commercially available snake venoms.

Private practice in anaesthesia: A comprehensive analysis.

The idea of a 'private practising anaesthesiologist'is generally that of a busy practitioner running from case to case, from one nursing home to the other, at all times of the day and night with no time for academics, teaching and family life.But is that really so? Is taking up a career in private practice going to be so full of hardships?There are several advantages of choosing private practice in anaesthesia. To survive in private practice, you need to be very confident in your work, skilful, punctual and good in communication. You can be your own master as a private practitioner. Private practice in anaesthesia is both challenging and interesting. This article, written by private practitioners in anaesthesia who have gone through the exciting and mundane phases of private practice examines the pro and cons of private practice; this can possibly help postgraduate students contemplating to take up private practice as a career.

Evaluating the effect of strengthening nurse midwifery pre-service education in two Indian states: A single group pre - and post - intervention study.

BACKGROUND: The high focus states of India have higher maternal and neonatal mortality rates as compared to the national average. The quality of pre-service education (PSE) in nursing midwifery institutions in these states was found to be suboptimal. In 2013, Government of India implemented the PSE strengthening program across all public sector nursing midwifery institutions. The program focused on strengthening educational processes, training infrastructure, institutional management and clinical site practices by implementing a set of performance standards. OBJECTIVE: To evaluate the effect of PSE strengthening program on institutional performance and maternal neonatal health (MNH) related competences of nursing midwifery students and faculty. DESIGN: Single group pre-post intervention study. SETTINGS: 15 sampled public sector nursing midwifery institutions in the states of Madhya Pradesh and Odisha, India. PARTICIPANTS: Final-year students and faculty involved in teaching MNH subjects. METHODS: Performance of 15 sampled institutions was assessed at baseline, midline and endline using the performance standards. Additionally, competences of 232, 295 and 298 students and 64, 62 and 63 faculty members at baseline, midline and endline respectively were assessed on six MNH related practices using objective structured clinical examination (OSCE). RESULTS: None of the institutions met 70% standards during baseline. At endline, 13 of the 15 institutions met these standards. The mean OSCE scores of students and faculty at baseline was 17.1 (SD: 8.0) and 23.5 (SD: 14.3) out of 76 respectively. It significantly increased to 66.4 (SD: 8.0) and 71.1 (SD: 5.2) during the endline. The proportion of students and faculty found competent (achieved 75% in OSCE) also significantly increased from none at baseline to 91% and 98% respectively, at endline. CONCLUSION: The combination of attributes included in the PSE strengthening program may have contributed to improvements in institutional performance as well as MNH related competences of nursing midwifery students and faculty.

First-hand knowledge about snakes and snake-bite management: an urgent need.

Snake-bite is a well-known but fairly ignored medical problem in India. Lack of precise first aid knowledge for snake-bite is a substantial reason for its severe fatality in human beings. The present study is comprised of a pilot survey that assesses and evaluates the knowledge of people of different occupations (teachers, students, farmers, medical residents, and miscellaneous) about snakes and snake-bite management. The pilot survey was conducted through a well-structured open-ended questionnaire about experiences with snakes and snake-bites and first aid measures for accidental snake-bites. Proper knowledge of snakes and snake-bite management was either diminutive or absent in the majority of the subjects, especially amongst teachers. Even the medical professionals were not well acquainted with knowledge about snakes and snake-bite management. Only 13% knew about 'big four', 18% knew 'dry bite', and 21% of subjects knew about anti-snake venom (ASV) used in India. 39% of subjects knew about the whereabouts of traditional healer. Only 12% of subjects, mostly medical residents, knew of any bedside test for diagnosis of snake-bite, and 11% of respondents also knew of LD50 of Indian cobra. A well-timed first aid treatment is always decisive in the management of life-threatening snake-bite cases but the present survey has found that most of the study groups had inadequate and little misleading fundamental knowledge comprising regional snakes, first aid measures for accidental snake-bite, and welfare schemes for snake-bite victims. Therefore, the present study proposes to conduct more such appraisals and strengthening of education curricula on snake-bite that would surely inculcate an adequate level of primary skill in ignorant societies.

Analysis of solid tumor mutation profiles in liquid biopsy.

Liquid biopsy is increasingly gaining traction as an alternative to invasive solid tumor biopsies for prognosis, treatment decisions, and disease monitoring. Matched tumor-plasma samples were collected from 180 patients across different cancers with >90% of the samples below Stage IIIB. Tumors were profiled using next-generation sequencing (NGS) or quantitative PCR (qPCR), and the mutation status was queried in the matched plasma using digital platforms such as droplet digital PCR (ddCPR) or NGS for concordance. Tumor-plasma concordance of 82% and 32% was observed in advanced (Stage IIB and above) and early (Stage I to Stage IIA) stage samples, respectively. Interestingly, the overall survival outcomes correlated to presurgical/at-biopsy ctDNA levels. Baseline ctDNA stratified patients into three categories: (a) high ctDNA correlated with poor survival outcome, (b) undetectable ctDNA with good outcome, and (c) low ctDNA whose outcome was ambiguous. ctDNA could be a powerful tool for therapy decisions and patient management in a large number of cancers across a variety of stages.

Topical Delivery of Erythromycin Through Cubosomes for Acne.

BACKGROUND: Topical delivery is an attractive route for local and systemic treatment. The novel topical application has many advantages like averting the GI-irritation, preventing the metabolism of drugs in the liver and increasing the bioavailability of the drug over the conventional dosage forms. OBJECTIVE: The aim of present work was to prepare and characterized erythromycin encapsulated cubosomes using different concentrations of glyceryl monooleate and poloxamer 407 by the emulsification method. METHODS: The prepared dispersion of cubosomes was characterized for surface morphology, particle size, entrapment efficiency and in vitro release. Further, optimized formulation was converted to cubosomal gel by incorporating carbopol 934 at different concentrations. The prepared gel was characterized for homogeneity, pH, viscosity, spreadibility, drug content and in vitro drug release study. RESULTS: The result of optimized cubosomes showed average particle size of 264.5±2.84nm and entrapment efficiency about 95.29±1.32 % and the pH of optimized cubosomal was found to be 6.5, viscosity 2475-8901(cp), drug content 95.29% and the spreadability was found to be 11.74 gm.cm/sec. The in vitro drug release kinetics of optimized formulation was found to follow Korsmeyer peppas model having highest R2 value 0.835 and in vitro drug release of optimized erythromycin loaded cubosomal gel and plain drug gel in 24 hr was found to be 89.91±0.73 and 88.64±2.16, while in 36 hr plain drug gel and cubosomal gel showed drug release about 87.64±0.97 and 91.55±1.09, and sustained release was obtained after 24 hr in case of cubosomal gel. CONCLUSION: Thus, as a whole it can be concluded that erythromycin loaded cubosomes are effective in topically delivering drug in sustained and non-invasive manner for treatment and prevention of acne.

Epidemiological profile of snake-bite cases from Haryana: A five year (2011-2015) retrospective study.

Varieties of venomous snakes inhabit in the world which accidentally take thousands of human lives every year. This severe medical emergency constantly persuades national and international health agencies to look at efficient epidemiological profiling of snake-bite cases for the proper management of this sympathetic problem. Establishing the accurate database of snake-bite in humans from different localities of India may perhaps lack certainty due to few inevitable reasons such as consideration of this problem as less emergent problem in disparity to pesticide poisoning, difficulty in the accessibility to rural and tribal areas where chances of snake-bite remain ceiling, lack of inspiring models of snake-bite management training, reduced reporting system, and pitiable maintenance of hospital data in India. Therefore, the present modest study was carried out to explore valuable information regarding snake-bite problem in Haryana. Factual data on snake-bite incidences happened from 2011 to 2015 were collected from government hospitals and medical institutes of Haryana. This retrospective study disclosed a few characteristic points related to the frequency of snake-bite cases, gender involved, anti-snake venom (ASV) treatment, and numbers of deaths with snake-bite. Records revealed a total of 6555 cases of snake-bite including 130 deaths reported in Haryana during the study period. A significant variation in the occurrence of snake-bite cases was also recorded in different areas of Haryana. There was a huge database of recorded snake-bite cases from government medical institute but district wise survey disclosed the maximum number of snake-bite incidences, especially amongst males from Panchkula. The present study has provided a more updated and comprehensive record of snake-bite from Haryana during 2011-2015. A huge burden of snake-bite amongst human was found in Haryana; hence, the findings of this study purposely enlighten people about the size of this problem in the selected region. However, this study also remained limited due to lack of information on a few important parameters and availability of homogeneous data.

Blending virtual with conventional learning to improve student midwifery skills in India.

India's state of Bihar has suboptimal quality of pre-service training for auxiliary nurse midwives. To address this, state government of Bihar implemented a blended training model to supplement conventional classroom teaching with virtual training. A 72-hour virtual training package with updated content on key maternal and newborn health practices was developed for final year students and broadcasted from one instructor location simultaneously to two auxiliary nurse midwives training centres. This pre-post intervention study compared skills of two auxiliary nurse midwife student cohorts. Eighty-five students from pre-intervention cohort of academic year 2012-13, received only conventional teaching during the final year. The 51 students in the post-intervention cohort from successive academic year 2013-14, received a combination of the both conventional and virtual training. The two cohorts were objectively assessed on identified midwifery skills. A passing score was set at achieving 75% or higher. The students exposed to blended learning scored 32.57 points (p = <0.001) more than their counterparts, who received only conventional teaching. In the post-intervention cohort, 55% students (N = 28) passed as compared to none in the pre-intervention cohort. We found blended learning approach effectively improved access to quality training, and identified key midwifery skills of auxiliary nurse midwife students from remote locations.

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

OBJECTIVE: Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. DESIGN: Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. SETTING: Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. PARTICIPANTS: Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. RESULTS: The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. CONCLUSION: Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it.

Data in support of poisoning related mortalities from southern Himachal Pradesh.

Poisoning has always been pointed as one of the leading causes of human death throughout the world. Despite the best efforts made by many research institutes, the worldwide true figure on mortalities with poisoning could never be achieved due to many reasons. One of the main reasons is the unavailability of complete database from the rural and catchment areas of the world where these types of incidents are usual. People can be made aware about this problem by presenting data articles on regular basis, therefore to mark a resource document these data should be regularly up-dated. The current data report is a briefing of types and trends of chemical poisoning amongst human in southern hilly region of Himachal Pradesh (HP), India. This research database is an outcome of five year retrospective study based on assessment of records pertaining human deaths associated with poisoning occurred in southern Himachal Pradesh, and reported at State Forensic Science Laboratory (SFSL), Junga during 2010-14. Cases where ethyl alcohol was detected have been put under exclusion criterion. All the cases were reviewed and summarized in terms of yearly and monthly frequency of reports wrapping important information portraying the involvement of gender, age, locality, types of poison, and mode of death in the poisoning incidents. Review of these scientific reports showed some notable figures having a direct concern with public and legal domains to promote risk reduction and prevention of chemical poisonings.

Bored in the USA: Experience sampling and boredom in everyday life.

We report new evidence on the emotional, demographic, and situational correlates of boredom from a rich experience sample capturing 1.1 million emotional and time-use reports from 3,867 U.S. adults. Subjects report boredom in 2.8% of the 30-min sampling periods, and 63% of participants report experiencing boredom at least once across the 10-day sampling period. We find that boredom is more likely to co-occur with negative, rather than positive, emotions, and is particularly predictive of loneliness, anger, sadness, and worry. Boredom is more prevalent among men, youths, the unmarried, and those of lower income. We find that differences in how such demographic groups spend their time account for up to one third of the observed differences in overall boredom. The importance of situations in predicting boredom is additionally underscored by the high prevalence of boredom in specific situations involving monotonous or difficult tasks (e.g., working, studying) or contexts where one's autonomy might be constrained (e.g., time with coworkers, afternoons, at school). Overall, our findings are consistent with cognitive accounts that cast boredom as emerging from situations in which engagement is difficult, and are less consistent with accounts that exclusively associate boredom with low arousal or with situations lacking in meaning. (PsycINFO Database Record

Effectiveness of virtual classroom training in improving the knowledge and key maternal neonatal health skills of general nurse midwifery students in Bihar, India: A pre- and post-intervention study.

BACKGROUND: In 2008-09, the National Health Systems Resource Center of India reported overall quality of nurse-midwifery education in Bihar as grossly sub-optimal. To address this, we implemented a competency-based training using virtual classrooms in two general nurse midwives (GNM) schools of Bihar. The students from remotely located nursing institutions were now able to see live demonstrations of maternal and newborn health (MNH) practices performed by a trained faculty on simulation models at instructor location. OBJECTIVE: To evaluate the effectiveness of virtual classroom training in improving the MNH-related skills of the nursing-midwifery students in Bihar, India. DESIGN: This study used a pre- and post-intervention design without a control group. SETTINGS: Students from two public GNM schools of Bihar. PARTICIPANTS: Final-year students from both the GNM schools who have completed their coursework in MNH. METHOD: A total of 83 students from selected GNM schools were assessed for their competencies in six key MNH practices using objective structured clinical examination method prior to intervention. A 72hour standardized training package was then implemented in these schools through virtual classroom approach. Post-intervention, 92 students from the next batch who attended virtual training were assessed for the same competencies. RESULTS: The mean student score assessed before the intervention was 21.3 (95% CI, 19.9-22.6), which increased to 62.0 (95% CI, 60.3-63.7) post-intervention. This difference was statistically significant. When adjusted for clustering using linear regression analysis, the students in post-intervention scored 52.3 (95% CI, 49.4%-55.3%) percentage points higher than pre-intervention, and this was statistically significant. CONCLUSION: Virtual classroom training was found to be effective in improving knowledge and key MNH skills of GNM students in Bihar, India.

Reconstruction of audio waveforms from spike trains of artificial cochlea models.

Spiking cochlea models describe the analog processing and spike generation process within the biological cochlea. Reconstructing the audio input from the artificial cochlea spikes is therefore useful for understanding the fidelity of the information preserved in the spikes. The reconstruction process is challenging particularly for spikes from the mixed signal (analog/digital) integrated circuit (IC) cochleas because of multiple non-linearities in the model and the additional variance caused by random transistor mismatch. This work proposes an offline method for reconstructing the audio input from spike responses of both a particular spike-based hardware model called the AEREAR2 cochlea and an equivalent software cochlea model. This method was previously used to reconstruct the auditory stimulus based on the peri-stimulus histogram of spike responses recorded in the ferret auditory cortex. The reconstructed audio from the hardware cochlea is evaluated against an analogous software model using objective measures of speech quality and intelligibility; and further tested in a word recognition task. The reconstructed audio under low signal-to-noise (SNR) conditions (SNR < -5 dB) gives a better classification performance than the original SNR input in this word recognition task.

Linear Methods for Efficient and Fast Separation of Two Sources Recorded with a Single Microphone.

This letter addresses the problem of separating two speakers from a single microphone recording. Three linear methods are tested for source separation, all of which operate directly on sound spectrograms: (1) eigenmode analysis of covariance difference to identify spectro-temporal features associated with large variance for one source and small variance for the other source; (2) maximum likelihood demixing in which the mixture is modeled as the sum of two gaussian signals and maximum likelihood is used to identify the most likely sources; and (3) suppression-regression, in which autoregressive models are trained to reproduce one source and suppress the other. These linear approaches are tested on the problem of separating a known male from a known female speaker. The performance of these algorithms is assessed in terms of the residual error of estimated source spectrograms, waveform signal-to-noise ratio, and perceptual evaluation of speech quality scores. This work shows that the algorithms compare favorably to nonlinear approaches such as nonnegative sparse coding in terms of simplicity, performance, and suitability for real-time implementations, and they provide benchmark solutions for monaural source separation tasks.

Tissue-engineered buccal mucosa urethroplasty-clinical outcomes.

INTRODUCTION: Whilst buccal mucosa is the most versatile tissue for urethral replacement, the quest continues for an ideal tissue replacement for the urethra when substantial tissue transfer is needed. Previously we described the development of autologous tissue-engineered buccal mucosa (TEBM). Here we report clinical outcomes of the first human series of its use in substitution urethroplasty. METHODOLOGY: Five patients with urethral stricture secondary to lichen sclerosus (LS) awaiting substantial substitution urethroplasty elected to undergo urethroplasty using TEBM, with full ethics committee support. Buccal mucosa biopsies (0.5 cm) were obtained from each patient. Keratinocytes and fibroblasts were isolated and cultured, seeded onto sterilised donor de-epidermised dermis, and maintained at air-liquid interface for 7-10 d to obtain full-thickness grafts. These grafts were used for urethroplasty in a one-stage (n=2) or a two-stage procedure (n=3). Follow-up was performed at 2 and 6 wk, at 3, 6, 9, and 12 mo, and every 6 mo thereafter. RESULTS: Follow-up ranged from 32 to 37 mo (mean, 33.6). The initial graft take was 100%, as assessed by visual inspection. Subsequently, one patient had complete excision of the grafted urethra and one required partial graft excision, for fibrosis and hyperproliferation of tissue, respectively. Three patients have a patent urethra with the TEBM graft in situ, although all three required some form of instrumentation. CONCLUSIONS: Whilst TEBM may in the future offer a clinically useful autologous urethral replacement tissue, in this group of patients with LS urethral strictures, it was not without complications, namely fibrosis and contraction in two of five patients.