Temporal change in prevalence of BMI categories in India: patterns across States and Union territories of India, 1999-2021.

BACKGROUND: The problem of overweight/obesity often coexists with the burden of undernutrition in most low- and middle-income countries. BMI change in India incorporating the most recent trends has been under-researched. METHODS: This repeated cross-sectional study of 1,477,885 adults in India analyzed the prevalence of different categories of BMI among adults (age 20-54) in 4 rounds of National Family Health Surveys (1998-1999, 2005-2006, 2015-2016, and 2019-2021) for 36 states/UTs. State differences across time were harmonized for accurate analysis. The categories were Severely/Moderately Thin (BMI < 17.0), Mildly Thin (17.0-18.4), Normal (18.5-24.9), Overweight (25.0-29.9), and Obese (≥ 30.0). We also estimated change in Standardized Absolute Change (SAC), ranking of states, and headcount burden to quantify the trend of BMI distribution across time periods for all-India, urban/rural residence, and by states/UTs. RESULTS: The prevalence of thinness declined from 31.7% in 1999 to 14.2% in 2021 for women, and from 23.4% in 2006 to 10.0% in 2021 for men. Obesity prevalence increased from 2.9% (1999) to 6.3% (2021) for women, and from 2.0% (2006) to 4.2% (2021) for men. In 2021, the states with the highest obesity prevalence were Puducherry, Chandigarh, and Delhi. These states also had a high prevalence of overweight. Dadra and Nagar Haveli and Diu, Gujarat, Jharkhand, and Bihar had the highest prevalence of severe/moderately thin. Prevalence of extreme categories (severely/moderately thin and obese) was larger in the case of women than men. While States/UTs with a higher prevalence of thin populations tend to have a larger absolute burden of severe or moderate thinness, the relationship between headcount burden and prevalence for overweight and obese is unclear. CONCLUSIONS: We found persistent interstate inequalities of undernutrition. Tailored efforts at state levels are required to further strengthen existing policies and develop new interventions to target both forms of malnutrition.

Early-Neonatal, Late-Neonatal, Postneonatal, and Child Mortality Rates Across India, 1993-2021.

Importance: The global success of the child survival agenda depends on how rapidly mortality at early ages after birth declines in India, and changes need to be monitored to evaluate the status. Objective: To understand the disaggregated patterns of decrease in early-life mortality across states and union territories (UTs) of India. Design, Setting, and Participants: Repeated cross-sectional data from the 5 rounds of the National Family Health Survey conducted in 1992-1993, 1998-1999, 2005-2006, 2015-2016, and 2019-2021 were used in a representative population-based study. The study was based on data of children born in the past 5 years with complete information on date of birth and age at death. The analysis was conducted in February 2024. Exposure: Time and geographic units. Main Outcomes and Measures: Mortality rates were computed for 4 early-life periods: early-neonatal (first 7 days), late-neonatal (8-28 days), postneonatal (29 days to 11 months), and child (12-59 months). For early and late neonatal periods, the rates are expressed as deaths per 1000 live births, for postneonatal, as deaths per 1000 children aged at least 29 days and for child, deaths per 1000 children aged at least 1 year. These are collectively mentioned as deaths per 1000 for all mortalities. The relative burden of each of the age-specific mortalities to total mortality in children younger than 5 years was also computed. Results: The final analytical sample included 33 667 (1993), 29 549 (1999), 23 020 (2006), 82 294 (2016), and 64 242 (2021) children who died before their fifth birthday in the past 5 years of each survey. Mortality rates were lowest for the late-neonatal and child periods; early-neonatal was the highest in 2021. Child mortality experienced the most substantial decrease between 1993 and 2021, from 33.5 to 6.9 deaths per 1000, accompanied by a substantial reduction in interstate inequalities. While early-neonatal (from 33.5 to 20.3 deaths per 1000), late-neonatal (from 14.1 to 4.1 deaths per 1000), and postneonatal (from 31.0 to 10.8 deaths per 1000) mortality also decreased, interstate inequalities remained notable. The mortality burden shifted over time and is now concentrated during the early-neonatal (48.3% of total deaths in children younger than 5 years) and postneonatal (25.6%) periods. A stagnation or worsening for certain states and UTs was observed from 2016 to 2021 for early-neonatal, late-neonatal, and postneonatal mortality. If this pattern continues, these states and UTs will not meet the United Nations Sustainable Development Goal targets related to child survival. Conclusions and Relevance: In this repeated cross-sectional study of 5 time periods, the decrease in mortality during early-neonatal and postneonatal phases of mortality was relatively slower, with notable variations across states and UTs. The findings suggest that policies pertaining to early-neonatal and postneonatal mortalities need to be prioritized and targeting of policies and interventions needs to be context-specific.

Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993-2021.

BACKGROUND: Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors. METHODS: We used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15-49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021. RESULTS: The prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1- 21·2%) in 1993, to 9·4% (95% CI: 9·3-9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3-28·6%) and Mizoram (18·9%, 95% CI: 17·2-20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1-14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5-13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15-19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021. CONCLUSIONS: The existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030.

This study looked at the trends in unmet need for family planning in India, which is defined as the percentage of women of reproductive age who want to delay or limit childbearing but are not using any contraceptive method. A public dataset was used to analyze national and sub-national trends from 1993 to 2021. It was determined that although the percentage prevalence of unmet need decreased in the last 30 years, there were still a substantial number of women with unmet need in 2021. More than half of these women were in Uttar Pradesh, Bihar, Maharashtra, and West Bengal. Furthermore, it was found that percentage prevalence of unmet need was relatively higher amongst younger women and those belonging to poorer households in 2021. Initiatives and policies aimed at reducing unmet need for family planning should be implemented while considering geographic, socioeconomic, and demographic differences.

Synergistic Antibacterial Activity of Gallic Acid Based Chalcone Indl 2 by Inhibiting Efflux Pump Transporters.

As a part of novel discovery of drugs from natural resources, present study was undertaken to explore the antibacterial potential of chalcone Indl-2 in combination with different group of antibiotics. MIC of antibiotics was reduced up to eight folds against the different cultures of E. coli by both chalcones. Among the two compounds, the i. e. 1-(3', 4,'5'-trimethoxyphenyl)-3-(3-Indyl)-prop-2-enone (6, Indl-2), a chalcone derivative of gallic acid (Indl-2) was better along with tetracycline (TET) worked synergistically and was found to inhibit efflux transporters as obvious by ethidium bromide efflux confirmed by ATPase assays and docking studies. In combination, Indl-2 kills the MDREC-KG4 cells, post-antibiotic effect (PAE) of TET was prolonged and mutant prevention concentration (MPC) of TET was also decreased. In-vivo studies revealed that Indl-2 reduces the concentration of TNF-α. In acute oral toxicity study, Indl-2 was non-toxic and well tolerated up-to dose of 2000 mg/kg. Perhaps, the study is going to report gallic acid derived chalcone as synergistic agent acting via inhibiting the primary efflux pumps.

Peripheral Linker Mediates Acyl Carrier Protein's Recognition of Dehydratase and Stabilizes Type-I Mycobacterium tuberculosis Fatty Acid Synthase.

Incomplete structural details of Mycobacterium tuberculosis (Mtb) fatty acid synthase-I (FAS-I) at near-atomic resolution have limited our understanding of the shuttling mechanism of its mobile acyl carrier protein (ACP). Here, we have performed atomistic molecular dynamics simulation of Mtb FAS-I with a homology-modeled structure of ACP stalled at dehydratase (DH) and identified key residues that mediate anchoring of the recognition helix of ACP near DH. The observed distance between catalytic residues of ACP and DH agrees with that reported for fungal FAS-I. Further, the conformation of the peripheral linker is found to be crucial in stabilizing ACP near DH. Correlated interdomain motion is observed between DH, enoyl reductase, and malonyl/palmitoyl transferase, consistent with prior experimental reports of fungal and Mtb FAS-I.

Prevalence of girl and boy child marriage across states and Union Territories in India, 1993-2021: a repeated cross-sectional study.

BACKGROUND: India's success in eliminating child marriage is crucial to the achievement of the Sustainable Development Goal target 5.3. We aimed to estimate the prevalence of child marriage in girls and boys in India and describe its change across 36 states and Union Territories between 1993 and 2021. METHODS: For this cross-sectional study, data from five National Family Health Surveys from 1993, 1999, 2006, 2016, and 2021 were used. The study included 310 721 women aged 20-24 years between 1993 and 2021 and 43 436 men aged 20-24 years between 2006 and 2021. Child marriage was defined as marriage in individuals younger than 18 years for men and women. We calculated the annual change in prevalence during the study period for states and Union Territories and estimated the population headcount of child brides and grooms. FINDINGS: Child marriage declined during 1993 to 2021. The all-India prevalence of child marriage in girls declined from 49·4% (95% CI 48·1-50·8) in 1993 to 22·3% (21·9-22·7) in 2021. Child marriage in boys declined from 7·1% (6·9-30·8) in 2006 to 2·2% (1·8-2·7) in 2021. The largest decreases in child marriage occurred between 2006 and 2016. Between 2016 and 2021, a few states and Union Territories saw an increase in prevalence of child marriage in girls (n=6) and boys (n=8) despite declines in the all-India prevalence. In 2021, 13 464 450 women aged 20-24 years and 1 454 894 men aged 20-24 years were estimated to be married as children. INTERPRETATION: One in five girls and nearly one in six boys are still married below the legal age of marriage in India. There remains an urgent need for strengthened national and state-level policy to eliminate child marriage by 2030. FUNDING: Bill & Melinda Gates Foundation.

Natural Language Processing-Assisted Classification Models to Confirm Monoclonal Gammopathy of Undetermined Significance and Progression in Veterans' Electronic Health Records.

PURPOSE: To develop and validate natural language processing (NLP)-assisted machine learning (ML)-based classification models to confirm diagnoses of monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) from electronic health records (EHRs) in the Veterans Health Administration (VHA). MATERIALS AND METHODS: We developed precompiled lexicons and classification rules as features for the following ML classifiers: logistic regression, random forest, and support vector machines (SVMs). These features were trained on 36,044 EHR documents from a random sample of 400 patients with at least one International Classification of Disease code for MGUS diagnosis from 1999 to 2021. The best-performing feature combination was calibrated in the validation set (17,826 documents/200 patients) and evaluated in the testing set (9,250 documents/100 patients). Model performance in diagnosis confirmation was compared with manual chart review results (gold standard) using recall, precision, accuracy, and F1 score. For patients correctly labeled as disease-positive, the difference between model-identified diagnosis dates and the gold standard was also computed. RESULTS: In the testing set, the NLP-assisted classification model using SVMs achieved best performance in both MGUS and MM confirmation with recall/precision/accuracy/F1 of 98.8%/93.3%/93.0%/96.0% for MGUS and 100.0%/92.3%/99.0%/96.0% for MM. Dates of diagnoses matched (±45 days) with those of gold standard in 73.0% of model-confirmed MGUS and 84.6% of model-confirmed MM. CONCLUSION: An NLP-assisted classification model can reliably confirm MGUS and MM diagnoses and dates and extract laboratory results using automated interpretation of EHR data. This algorithm has the potential to be adapted to other disease areas in VHA EHR system.

Corrigendum to- "Prevalence of Zero-Food among infants and young children in India: patterns of change across the States and Union Territories of India, 1993-2021".

[This corrects the article DOI: 10.1016/j.eclinm.2023.101890.].

Mapping of long stretches of highly conserved sequences in over 6 million SARS-CoV-2 genomes.

We identified 11 conserved stretches in over 6.3 million SARS-CoV-2 genomes including all the major variants of concerns. Each conserved stretch is ≥100 nucleotides in length with ≥99.9% conservation at each nucleotide position. Interestingly, six of the eight conserved stretches in ORF1ab overlapped significantly with well-folded experimentally verified RNA secondary structures. Furthermore, two of the conserved stretches were mapped to regions within the S2-subunit that undergo dynamic structural rearrangements during viral fusion. In addition, the conserved stretches were significantly depleted for zinc-finger antiviral protein (ZAP) binding sites, which facilitated the recognition and degradation of viral RNA. These highly conserved stretches in the SARS-CoV-2 genome were poorly conserved at the nucleotide level among closely related ß-coronaviruses, thus representing ideal targets for highly specific and discriminatory diagnostic assays. Our findings highlight the role of structural constraints at both RNA and protein levels that contribute to the sequence conservation of specific genomic regions in SARS-CoV-2.

Prevalence of zero-sanitation in India: Patterns of change across the states and Union Territories, 1993-2021.

Background: Ensuring universal access to safe sanitation by 2030 is a development priority for India. Doing so can help ensure improved physical and mental health outcomes. While the proportion of people in India with safe sanitation has risen dramatically over the past thirty years, much less is known about who has been most at risk for not having access to safe sanitation across India's states and Union Territories (UT) over this time period. We introduce the concept of zero-sanitation to fill this gap. Methods: Data from five National Family Health Surveys (NFHS) conducted in 1993, 1999, 2006, 2016, and 2021 from 36 states and UT were used for this study. The study population consisted for all household individuals regardless of age in each survey round. Zero-sanitation was defined as those who have no access to a household toilet, and thus defecate in the open. We analyzed the percent prevalence of zero-sanitation in every state / UT at each time period in both urban and rural communities, as well as the population headcount burden in 2021. We calculated the absolute change on an annual basis to assess the change in percentage points of zero-sanitation across time periods at the all-India and state / UT levels. Results: The all-India prevalence of zero-sanitation declined from 70.3% (95% confidence interval (CI) = 70.2%-70.5%) in 1993 to 17.8% (95% CI = 17.7%-17.9%) in 2021. The median percent prevalence of zero-sanitation across states and UTs was 65.9% in 1993. By 2021, the median percent prevalence of zero-sanitation across states and UTs was 5.7%. This reduction corresponded with a reduction in the between state / UT inequality in zero-sanitation. Nevertheless, as of 2021, the prevalence of zero-sanitation was still above 20% in Bihar, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, and Uttar Pradesh. Additionally, as of 2021, almost 92% of individuals who were defecating in the open were experiencing zero-sanitation. Zero-sanitation remains most common in states such as Bihar, Punjab, Uttar Pradesh, and Assam. Nevertheless, at this current rate of improvement, every state and UT except for Sikkim and Chandigarh are on track to end open defecation by 2030. Conclusions: The concept of zero-sanitation is a useful tool in helping policy makers assess the extent to which sanitation coverage remains incomplete. When viewed through this lens, we see that open defecation remains most common among those who do not have a toilet. Addressing the myriad social determinants of sanitation access can help fill these gaps and ensure equitable sanitation coverage throughout India.

Progress on Sustainable Development Goal indicators in 707 districts of India: a quantitative mid-line assessment using the National Family Health Surveys, 2016 and 2021.

Background: India has committed itself to accomplishing the Sustainable Development Goals (SDGs) by 2030. Meeting these goals would require prioritizing and targeting specific areas within India. We provide a mid-line assessment of the progress across 707 districts of India for 33 SDG indicators related to health and social determinants of health. Methods: We used data collected on children and adults from two rounds of the National Family Health Survey (NFHS) conducted in 2016 and 2021. We identified 33 indicators that cover 9 of the 17 official SDGs. We used the goals and targets outlined by the Global Indicator Framework, Government of India and World Health Organization (WHO) to determine SDG targets to be met by 2030. Using precision-weighted multilevel models, we estimated district mean for 2016 and 2021, and using these values, computed the Annual Absolute Change (AAC) for each indicator. Using the AAC and targets, we classified India and each district as: Achieved-I, Achieved-II, On-Target and Off-Target. Further, when a district was Off-Target on a given indicator, we further identified the calendar year in which the target will be met post-2030. Findings: India is not On-Target for 19 of the 33 SDGs indicators. The critical Off-Target indicators include Access to Basic Services, Wasting and Overweight Children, Anaemia, Child Marriage, Partner Violence, Tobacco Use, and Modern Contraceptive Use. For these indicators, more than 75% of the districts were Off-Target. Because of a worsening trend observed between 2016 and 2021, and assuming no course correction occurs, many districts will never meet the targets on the SDGs even well after 2030. These Off-Target districts are concentrated in the states of Madhya Pradesh, Chhattisgarh, Jharkhand, Bihar, and Odisha. Finally, it does not appear that Aspirational Districts, on average, are performing better in meeting the SDG targets than other districts on majority of the indicators. Interpretation: A mid-line assessment of districts' progress on SDGs suggests an urgent need to increase the pace and momentum on four SDG goals: No Poverty (SDG 1), Zero Hunger (SDG 2), Good Health and Well-Being (SDG 3) and Gender Equality (SDG 5). Developing a strategic roadmap at this time will help India ensure success with regards to meeting the SDGs. India's emergence and sustenance as a leading economic power depends on meeting some of the more basic health and social determinants of health-related SDGs in an immediate and equitable manner. Funding: This work was funded by the Bill and Melinda Gates Foundation, INV-002992.

SAM C-GAN: a method for removal of face masks from masked faces.

The past years of COVID-19 have attracted researchers to carry out benchmark work in face mask detection. However, the existing work does not focus on the problem of reconstructing the face area behind the mask and completing the face that can be used for face recognition. In order to address this problem, in this work we have proposed a spatial attention module-based conditional generative adversarial network method that can generate plausible images of faces without masks by removing the face masks from the face region. The method proposed in this work utilizes a self-created dataset consisting of faces with three types of face masks for training and testing purposes. With the proposed method, an SSIM value of 0.91231 which is 3.89% higher and a PSNR value of 30.9879 which is 3.17% higher has been obtained as compared to the vanilla C-GAN method.

Prevalence of Zero-Food among infants and young children in India: patterns of change across the States and Union Territories of India, 1993-2021.

Background: The extent of food deprivation and insecurity among infants and young children-a critical phase for children's current and future health and well-being-in India is unknown. We estimate the prevalence of food deprivation among infants and young children in India and describe its evolution over time at sub-national levels. Methods: Data from five National Family Health Surveys (NFHS) conducted in 1993, 1999, 2006, 2016 and 2021 for the 36 states/Union Territories (UTs) of India were used. The study population consisted of the most recent children (6-23 months) born to mothers (aged 15-49 years), who were alive and living with the mother at the time of survey (n = 175,614 after excluding observations that had no responses to the food question). Food deprivation was defined based on the mother's reporting of the child having not eaten any food of substantial calorific content (i.e., any solid/semi-solid/soft/mushy food types, infant formula and powdered/tinned/fresh milk) in the past 24 hours (h), which we labelled as "Zero-Food". In this study, we analyzed Zero-Food in terms of percent prevalence as well as population headcount burden. We calculated the Absolute Change (AC) to quantify the change in the percentage points of Zero-Food across time periods for all-India and by states/UTs. Findings: The prevalence of Zero-Food in India marginally declined from 20.0% (95% CI: 19.3%-20.7%) in 1993 to 17.8% (95% CI: 17.5%-18.1%) in 2021. There were considerable differences in the trajectories of change in the prevalence of Zero-Food across states. Chhattisgarh, Mizoram, and Jammu and Kashmir experienced high increase in the prevalence of Zero-Food over this time period, while Nagaland, Odisha, Rajasthan and Madhya Pradesh witnessed a significant decline. In 2021, Uttar Pradesh (27.4%), Chhattisgarh (24.6%), Jharkhand (21%), Rajasthan (19.8%) and Assam (19.4%) were states with the highest prevalence of Zero-Food. As of 2021, the estimated number of Zero-Food children in India was 5,998,138, with the states of Uttar Pradesh (28.4%), Bihar (14.2%), Maharashtra (7.1%), Rajasthan (6.5%), and Madhya Pradesh (6%) accounting for nearly two-thirds of the total Zero-Food children in India. Zero-Food in 2021 was concerningly high among children aged 6-11 months (30.6%) and substantial even among children aged 18-23 months (8.5%). Overall, socioeconomically advantaged groups had lower prevalence of Zero-Food than disadvantaged groups. Interpretation: Concerted efforts at the national and state levels are required to further strengthen existing policies, and design and develop new ones to provide affordable food to children in a timely and equitable manner to ensure food security among infants and young children. Funding: This study was supported by a grant from the Bill & Melinda Gates Foundation INV-002992.

CRISPR-Cas: A robust technology for enhancing consumer-preferred commercial traits in crops.

The acceptance of new crop varieties by consumers is contingent on the presence of consumer-preferred traits, which include sensory attributes, nutritional value, industrial products and bioactive compounds production. Recent developments in genome editing technologies provide novel insight to identify gene functions and improve the various qualitative and quantitative traits of commercial importance in plants. Various conventional as well as advanced gene-mutagenesis techniques such as physical and chemical mutagenesis, CRISPR-Cas9, Cas12 and base editors are used for the trait improvement in crops. To meet consumer demand, breakthrough biotechnologies, especially CRISPR-Cas have received a fair share of scientific and industrial interest, particularly in plant genome editing. CRISPR-Cas is a versatile tool that can be used to knock out, replace and knock-in the desired gene fragments at targeted locations in the genome, resulting in heritable mutations of interest. This review highlights the existing literature and recent developments in CRISPR-Cas technologies (base editing, prime editing, multiplex gene editing, epigenome editing, gene delivery methods) for reliable and precise gene editing in plants. This review also discusses the potential of gene editing exhibited in crops for the improvement of consumer-demanded traits such as higher nutritional value, colour, texture, aroma/flavour, and production of industrial products such as biofuel, fibre, rubber and pharmaceuticals. In addition, the bottlenecks and challenges associated with gene editing system, such as off targeting, ploidy level and the ability to edit organelle genome have also been discussed.

Lemon grass essential oil improves Gladiolus grandiflorus postharvest life by modulating water relations, microbial growth, biochemical activity, and gene expression.

Gladiolus (Gladiolus grandiflorus Andrews) is a high-valued bulbous cut flower. However, the shorter postharvest life of the gladiolus, limits its marketing and commercial value. In the present investigation, the effect of lemon grass (LG) essential oil as an antimicrobial agent was studied towards increasing the vase life of gladiolus. The results revealed that as compared to control (distilled water), treatment with a lower concentration of 5 µL L-1 LG essential oil prolonged the vase life of gladiolus up to 11 days (d). Scanning Electron Microscope (SEM) observation indicated that the sample treated with 5 µL L-1 LG essential oil showed intact vasculature, suggesting reduced microbial blockage at the stem end which was further corroborated by microbial count. Biochemical analysis suggested an increased level of total soluble sugars, carotenoid content, lower MDA accumulation, and higher activity of antioxidant enzymes in LG treated flowers. Moreover, transcripts levels of genes associated with senescence viz., GgCyP1 and GgERS1a were downregulated, while expression of GDAD1 and antioxidant genes such as GgP5C5, GgPOD 1, GgMnSOD, and GgCAT1 were upregulated in LG treated cut spikes as compared to control. Among various treatments we have concluded that, the vase life of the gladiolus cut spike was improved along with the relative fresh flower weight and diameter of flower at the lower dose of 5 µL L-1 LG oil in the vase solution. Thus, LG oil as an eco-friendly agent has the potential to extend the postharvest life of cut flowers.

Patterns in the Prevalence of Unvaccinated Children Across 36 States and Union Territories in India, 1993-2021.

Importance: Children who do not receive any routine vaccinations (ie, who have 0-dose status) are at elevated risk of death, morbidity, and socioeconomic vulnerabilities that limit their development over the life course. India has the world's highest number of children with 0-dose status; analysis of national and subnational patterns is the first important step to addressing this problem. Objectives: To examine the patterns among children with 0-dose immunization status across all 36 states and union territories (UTs) in India over 29 years, from 1993 to 2021, and to elucidate the relative share of multiple geographic regions in the total geographic variation in 0-dose immunization. Design, Setting, and Participants: This repeated cross-sectional study analyzed all 5 rounds of India's National Family Health Survey (1992-1993, 1998-1999, 2005-2006, 2015-2016, and 2019-2021) to compare the prevalence of children with 0-dose status across time-space and geographic regions. The Integrated Public Use of Microdata Series was used to construct comparable geographic boundaries for states and UTs across surveys. The study included a total of 125 619 live children aged 12 to 23 months who were born to participating women. Main Outcomes and Measures: The outcome was a binary indicator of children's 0-dose vaccination status, coded as children aged 12 to 23 months at the time of the survey who had not received the first dose of the diphtheria-tetanus-pertussis-containing vaccine. The significance of each geographic unit was computed using the variance partition coefficient (VPC). Results: Among 125 619 children, the national prevalence of those with 0-dose status in India decreased from 33.4% (95% CI, 32.5%-34.2%) in 1993 to 6.6% (95% CI, 6.4%-6.8%) in 2021. A substantial reduction in the IQR of 0-dose prevalence across states from 30.1% in 1993 to 3.1% in 2021 suggested a convergence in state disparities. The prevalence in the northeastern states of Meghalaya (17.0%), Nagaland (16.1%), Mizoram (14.3%), and Arunachal Pradesh (12.6%) remained relatively high in 2021. Prevalence increased between 2016 and 2021 in 10 states, including several traditionally high-performing states and UTs, such as Telangana (1.16 percentage points) and Sikkim (0.92 percentage points). In 2021, 53.0% of children with 0-dose status resided in the populous states of Uttar Pradesh, Bihar, and Maharashtra. A multilevel analysis comparing the share of variation at the state, district, and cluster (primary sampling unit) levels revealed that clusters accounted for the highest share of the total variation in 2016 (44.7%; VPC [SE], 1.04 [0.32]) and 2021 (64.3%; VPC [SE], 0.38 [0.12]). Conclusions and Relevance: In this cross-sectional study, findings from approximately 3 decades of analysis suggest the need for sustained efforts to target populous states like Uttar Pradesh and Bihar and northeastern parts of India. The resurgence of 0-dose prevalence in 10 states highlights the importance of programs like Intensified Mission Indradhanush 4.0, a major national initiative to improve immunization coverage. Prioritizing small administrative units will be important to strengthening India's efforts to bring every child into the immunization regime.

A hybrid tiny YOLO v4-SPP module based improved face mask detection vision system.

Law offenders take advantage of face masks to conceal their identities and in the present time of the COVID-19 pandemic wearing face masks is a new norm which makes it a daunting task for the investigation agencies to identify the offenders. To address the issue of detection of people wearing face masks using surveillance cameras, we propose a novel face mask vision system that is based on an improved tiny YOLO v4 object detector. The face masks detection network of the proposed vision system is developed by integrating tiny YOLO v4 with spatial pyramid pooling (SPP) module and additional YOLO detection layer and tested and validated on a self-created face masks detection dataset consisting of more than 50,000 images. The proposed tiny YOLO v4-SPP network achieved a mAP (mean average precision) value of 64.31% on the employed dataset which was 6.6% higher than tiny YOLO v4. Specifically, for detection of the presence of a small object like a face mask on the face region, the proposed tiny YOLO v4-SPP based vision system achieved an AP (average precision) of 84.42% which was 14.05% higher than the original tiny YOLO v4 thus, ensuring that the proposed network is capable of accurate detection of a mask on the face region in real-time surveillance applications where visibility of complete face area is a guideline.

Small area variation in severe, moderate, and mild anemia among women and children: A multilevel analysis of 707 districts in India.

India is home to the highest global number of women and children suffering from anemia, with one in every two women impacted. India's current strategy for targeting areas with a high anemia burden is based on district-level averages, yet this fails to capture the substantial small area variation in micro-geographical (small area) units such as villages. We conducted statistical and econometric analyses to quantify the extent of small area variation in the three grades of anemia (severe, moderate, and mild) among women and children across 36 states/union territories and 707 districts of India. We utilized data from the fifth round of the National Family Health Survey conducted in 2019-21. The final analytic sample for analyses was 183,883 children aged 6-59 months and 690,153 women aged 15-49 years. The primary outcome variable for the analysis was the three anemia grades among women and children. We adopted a three-level and four-level logistic regression model to compute variance partitioning of anemia among women and children. We also computed precision-weighted prevalence estimates of women and childhood anemia across 707 districts and within-district, between-cluster variation using standard deviation (SD). For severe anemia among women, small area (villages or urban blocks) account for highest share (46.1%; Var: 0.494; SE: 0.150) in total variation followed by states (39.4%; Var: 0.422; SE: 0.134) and districts (12.8%; Var: 0.156; SE: 0.012). Similarly, clusters account for the highest share in the variation in severe (61.3%; Var: 0.899; SE: 0.069) and moderate (46.4%: Var: 0.398; SE: 0.011) anemia among children. For mild and moderate anemia among women, however, states were the highest source of variation. Additionally, we found a high and positive correlation between mean prevalence and inter-cluster SD of moderate and severe anemia among women and children. In contrast, the correlation was weaker for mild anemia among women (r = 0.61) and children (0.66). In this analysis, we are positing the critical importance of small area variation within districts when designing strategies for targeting high burden areas for anemia interventions.

The interplay of DNA methyltransferases and demethylases with tuberization genes in potato (Solanum tuberosum L.) genotypes under high temperature.

Potato is a temperate crop consumed globally as a staple food. High temperature negatively impacts the tuberization process, eventually affecting crop yield. DNA methylation plays an important role in various developmental and physiological processes in plants. It is a conserved epigenetic mark determined by the dynamic concurrent action of cytosine-5 DNA methyltransferases (C5-MTases) and demethylases (DeMets). However, C5-MTases and DeMets remain unidentified in potato, and their expression patterns are unknown under high temperatures. Here, we performed genome-wide analysis and identified 10 C5-MTases and 8 DeMets in potatoes. Analysis of their conserved motifs, gene structures, and phylogenetic analysis grouped C5-MTases into four subfamilies (StMET, StCMT3, StDRM, and StDNMT2) and DeMets into three subfamilies (StROS, StDML, and StDME). Promoter analysis showed the presence of multiple cis-regulatory elements involved in plant development, hormone, and stress response. Furthermore, expression dynamics of C5-MTases and DeMets were determined in the different tissues (leaf, flower, and stolon) of heat-sensitive (HS) and heat-tolerant (HT) genotypes under high temperature. qPCR results revealed that high temperature resulted in pronounced upregulation of CMT and DRM genes in the HT genotype. Likewise, demethylases showed strong upregulation in HT genotype as compared to HS genotype. Several positive (StSP6A and StBEL5) and negative (StSP5G, StSUT4, and StRAP1) regulators are involved in the potato tuberization. Expression analysis of these genes revealed that high temperature induces the expression of positive regulators in the leaf and stolon samples of HT genotype, possibly through active DNA demethylation and RNA-directed DNA methylation (RdDM) pathway components. Our findings lay a framework for understanding how epigenetic pathways synergistically or antagonistically regulate the tuberization process under high-temperature stress in potatoes. Uncovering such mechanisms will contribute to potato breeding for developing thermotolerant potato varieties.