Charge distribution studies in the epi-cadmium neutron induced fission of 238Pu

Studies on charge distribution have been carried out in the epi-cadmium neutron induced fission of 238Pu for the first time. Experimentally fractional cumulative yields (FCY) and independent yields (IY) of various fission products have been measured by using an off-line γ-ray spectrometric technique. From the FCY values, the charge distribution parameters such as the isobaric width parameter (σZ), most probable charge (ZP) and the charge polarization (ΔΖEXPT) as a function of fragment mass were obtained. On the other hand, from the measured IY values, isotopic width parameter (σA), the most probable mass (AP) and the elemental yields (YZ) of Sn, Sb, Te, I, Xe, Cs, Ba, La, Ce and Pr were determined by using a non-linear fit. From the YZ values, the proton even-odd effect (δp) was obtained for the first time. The isobaric and isotopic charge distribution parameters in the 238Pu(nf, f) reaction were compared with the similar data in the thermal neutron induced fission of 238Pu and other actinides to examine the role of excitation energy.

Independent isomeric yield ratios of fission products in the epi-cadmium neutron induced fission of 233U

The independent isomeric yield ratios (IR) of 128,130,132Sb, 131,133Te, 132,134,136I, 135Xe and 138Cs have been measured in the epi-cadmium neutron induced fission of 233U by using an off-line gamma-ray spectrometric technique. The average neutron energy of the epi-cadmium reactor neutron spectrum is 1.9 MeV. The root mean square fragment angular momenta (JRMS) were deduced from the IR values by using spin dependent statistical model analysis. The IR and JRMS values of considered fission products in the epi-cadmium neutron induced fission of 233U were compared with the literature data in the thermal neutron induced fission of 233U to examine the influence of excitation energy on nuclear structure effect.

Complementary and Alternative Medicine/Therapy for Tobacco Cessation in India: A Secondary Analysis of GATS-1 and 2

Background

India has nearly 267 million adult tobacco users, with a slowly improving quitting rate. Among the many approaches to quitting the habit, such as counseling, nicotine replacement therapy, nicotine patch or gum, and prescribed allopathic medicines. Complementary and alternative medicine/therapy (CAM), a thousand-year-old practice in India, may also prove to be a potential method in tobacco cessation; however, there is scarce literature on the extent of use of CAM among tobacco users who attempt to quit the habit. Therefore, this study attempts to examine the potential of CAM as a strategy for tobacco control in India.

Material and Methods

We undertook a secondary analysis of the data from both rounds of the Global Adult Tobacco Survey (GATS 2009 and 2016). The dependent variable included in the analysis was the use of traditional medicine as a method for quitting tobacco in three types of users-smokers, smokeless tobacco users, and dual users. The prevalence of CAM use was reported, and Chi-square test was applied to find the factors significantly associated with the use of CAM among tobacco users considering a P value of 0.05 to be statistically significant.

Results

The overall prevalence of traditional medicine use for GATS-1 was observed to be more among dual users (4%), while for GATS-2, it was highest among smokers (3%). For both rounds of the GATS survey, the use of traditional medicine was found to be higher among males, rural residents, users with no education or less than primary education, and the eastern region.

Conclusions

CAM has a promising potential for supporting tobacco cessation provided a concerted effort is undertaken to standardize pharmacopeia and establish robust clinical evidence. In addition, there is a need to create awareness, build the capacity of healthcare providers, and foster academic-industrial research in indigenous Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) systems.

Development of a multi-component tobacco cessation training package utilizing multiple approaches of intervention development for health care providers and patients attending non-communicable disease clinics of Punjab, India

Background

Providing patients with personalized tobacco cessation counseling that is culturally sensitive, and disease-specific from healthcare providers (HCPs) as part of their routine consultations is an approach that could be incorporated, using existing healthcare systems such as the Non-Communicable Disease (NCD) clinics. This paper describes the development of a multi-component culturally tailored, patient-centric, disease-specific tobacco cessation package utilizing multiple approaches of intervention development for healthcare providers and patients attending these clinics in Punjab, India, along with a proposed framework for implementation.

Methods

The proposed intervention package was developed in 6 stages. These included a review of literature for identifying successful cessation interventions for ethnic minority groups, co-production of the package with all stakeholders involved via a series of consultative meetings and workshops, understanding contextual factors of the state and 'factor-in' these in the package, pre-test of the package among HCPs and tobacco users using in-depth interviews, micro detailing and expansion of the package by drawing on existing theories of the Cascade Model and Trans-Theoretical Model and developing an evolving analysis plan through real-world implementation at two pilot districts by undertaking a randomized controlled trial, assessing implementer's experiences using a mixed-method with a primary focus on qualitative and economic evaluation of intervention package.

Results

A multi-component package consisting of a booklet (for HCPs), disease-specific pamphlets and short text messages (for patients; bilingual), and an implementation framework was developed using the 6-step process. A major finding from the in-depth interviews was the need for a specific capacity-building training program on tobacco cessation. Therefore, using this as an opportunity, we trained the in-service human resource and associated program managers at the state and district-level training workshops. Based on the feedback, training objectives were set and supported with copies of intervention package components. In addition, the role and function of each stakeholder were defined in the proposed framework.

Conclusion

Consideration of tobacco users' socio-cultural and patient-centric approach makes a robust strategy while developing and implementing an intervention providing an enlarged scope to improve care services for diversified socio-cultural communities.

Banning Loose Cigarettes and Other Tobacco Products in India: A Policy Analysis

BACKGROUND

Sale of single cigarettes (also known as singles or loosies) is a key driver for early initiation of smoking and is a leading contributor to the smoking epidemic in India. Sale of singles additionally deter implementation of tobacco control strategies of pictorial health warnings including plain packaging and defeat effective taxation and promote illicit trade. We review India's tobacco control policy responses towards banning singles and other products sold as loose tobacco and identify opportunities for future policy intervention especially in the context of the ongoing COVID-19 pandemic.

METHODS

Existing national and sub-national policy documents were analyzed for their content since the inception of the tobacco control laws in the country.

RESULTS

There are no effective provisions at national level to ban loose tobacco products in India. However, the implementation of multiple legislative and regulatory measures (Acts/circulars/letters/notifications/orders/court judgements) in 16 Indian states and jurisdictions provide sufficient legal framework to substantiate its complete ban pan India. While the majority of state governments have adopted state level measures, Rajasthan had issued specific directive to all the 33 districts banning loose cigarettes and other tobacco products. Himachal Pradesh introduced the most unique and comprehensive legislation, for banning the sale of cigarettes and beedis (Dated November 7, 2016). The most recent notification in the state of Maharashtra (September 24, 2020) is the first to leverage powers using a mix of national and state legislations including the legislation addressing the rapidly emerging challenge of managing COVID-19.

CONCLUSION

A robust national policy which supports strong provision to deter tobacco companies, their distribution network and vendors from selling singles or loose tobacco products is urgently needed. Such policy should be backed by cautionary messaging for consumers as well. Eliminating singles and loose tobacco sale will help in blunting tobacco use prevalence besides curbing spread of infectious diseases like COVID-19 pandemic.

E-cigarette retailer storefront availability following a nationwide prohibition of e-cigarettes in India: A multicentric compliance assessment

INTRODUCTION

This study aimed to assess the availability of retailer storefronts that continued to sell electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) in India, and characterise such retailers following the promulgation of 2019 Indian Ordinance and Act (Ordinance/Act) that prohibit ENDS/ENNDS nationwide.

METHODS

Discreet observations were conducted of retailer storefronts across different socioeconomic zones in nine major cities of India (Bengaluru, Chandigarh, Dehradun, Delhi, Indore, Kolkata, Ludhiana, Raipur, and Ranchi) from 28 November 2019 to 22 January 2020 to identify the availability of ENDS/ENNDS (i.e. electronic cigarettes, e-cigarette liquid, e-cigarette accessories, heated tobacco products (HTPs), and HTPs accessories). We report the number and proportion (%) of retailers that sold ENDS/ENNDS. Other characteristics of the retailers are also described, including indirect evaluation of the retailer's awareness of the Ordinance/Act.

RESULTS

Of the 199 retailer storefronts visited, 37 (18.6%) sold ENDS/ENNDS and, therefore, did not comply with the Ordinance/Act. The highest availability of non-compliant retailers was in Kolkata (n=26; 83.9%). The majority of the non-compliant retailers were tobacco retailers (n=35; 94.6%), sold e-cigarettes (n=22; 59.5%), and e-cigarette accessories (n=24; 64.9%). Although many of the non-compliant retailers displayed their ENDS/ENNDS products (n=33; 89.2%) and did not feature health warnings related to ENDS/ENNDS (n=32; 86.5%) in the stores, nearly 90% (n=33) were aware of the Ordinance/Act.

CONCLUSIONS

Despite a nationwide ban, ENDS/ENNDS are still available in major cities in India, and concentrated in a particular city. Indian authorities should focus on law enforcement to ensure that the prohibition is effectively implemented.

Fuelling the tuberculosis epidemic: The role of tobacco control in ending the TB emergency

BACKGROUND

Ending the TB epidemic by 2030 is among the key targets for countries to achieve Sustainable Development Goals. In current times we are grappling with dual burden of tuberculosis as well as tobacco use.

METHODS

There is sufficient evidence to establish that tobacco smoking significantly spikes up the risk of acquiring, developing and death among tuberculosis patients. Active or passive exposure to tobacco smoke is significantly associated with tuberculosis infection and tuberculosis disease, independent of a large number of other potential confounders.

RESULTS

Despite having substantial evidence about the impact of tobacco control measures, particularly tobacco cessation, on TB outcomes, the integration of TB and tobacco control still remains far-off.

CONCLUSION

It is high time when TB control programs must begin to address tobacco control as a potential preventive intervention to combat colliding epidemics of tobacco and tuberculosis. This white paper discusses about the role of tobacco control in reaching the ambitious goal of ending TB epidemic by 2030.

Tuberculosis-tobacco integration in the South-East Asia Region: policy analysis and implementation framework

SETTING

Despite overwhelming evidence for the association between tuberculosis (TB) and tobacco use, it remains neglected in the context of policy, planning and practice. There is limited evidence about the extent of integration of TB and tobacco control programmes in South-East Asia Region (SEAR) countries.

OBJECTIVE

To assess the level of TB-tobacco integration in 11 SEAR countries.

DESIGN

Cross-sectional study using a structured questionnaire addressed to TB and tobacco focal points at the World Health Organization Country Offices.

RESULTS

Apart from India, no country in the SEAR has a formal coordination mechanism for national TB and tobacco control programmes or a system of referral for tobacco users among TB patients for treatment of tobacco dependence. There is no joint planning, joint training or joint supervision and monitoring in any country.

CONCLUSION

There is poor integration between TB and tobacco control programmes in most SEAR countries. This assessment fed into the development of a regional framework for TB-tobacco integration, which outlines three strategies: 1) integrated patient-centred care and prevention; 2) joint TB tobacco actions covering policy development, planning, training and monitoring; and 3) research and innovation. Every country in the region should adopt the TB-tobacco integration framework to improve programme performance.

Open access tools for quality-assured and efficient data entry in a large, state-wide tobacco survey in India

Background: A large state-wide tobacco survey was conducted using modified version of pretested, globally validated Global Adult Tobacco Survey (GATS) questionnaire in 2015–22016 in Tamil Nadu, India. Due to resource constrains, data collection was carrid out using paper-based questionnaires (unlike the GATS-India, 2009–2010, which used hand-held computer devices) while data entry was done using open access tools. The objective of this paper is to describe the process of data entry and assess its quality assurance and efficiency.

Methods: In EpiData language, a variable is referred to as ‘field’ and a questionnaire (set of fields) as ‘record’. EpiData software was used for double data entry with adequate checks followed by validation. Teamviewer was used for remote training and trouble shooting. The EpiData databases (one each for each district and each zone in Chennai city) were housed in shared Dropbox folders, which enabled secure sharing of files and automatic back-up. Each database for a district/zone had separate file for data entry of household level and individual level questionnaire.

Results: Of 32,945 households, there were 111,363 individuals aged ≥15 years. The average proportion of records with data entry errors for a district/zone in household level and individual level file was 4% and 24%, respectively. These are the errors that would have gone unnoticed if single entry was used. The median (inter-quartile range) time taken for double data entry for a single household level and individual level questionnaire was 30 (24, 40) s and 86 (64, 126) s, respectively.

Conclusion: Efficient and quality-assured near-real-time data entry in a large sub-national tobacco survey was performed using innovative, resource-efficient use of open access tools.

Opening gambit: Strategic options to initiate the tobacco endgame

Endgame strategies to rapidly hasten the decline of tobacco are already well within reach; a few plausible policy options are outlined herein for policy practitioners, tobacco control advocates, and public health specialists. The implementation of these measures which already exist within the gamut of existing legislation requires the galvanization of political will. The options we essay include liquidating existing public investments in tobacco, holding tobacco companies accountable within the jurisdictions of their operations, fixing liability for injury and the imposition of realistic costs on insurance providers.

Clinical and biochemical phenotypes of adults with monoallelic and biallelic CYP24A1 mutations: evidence of gene dose effect

Mutations of the CYP24A1 gene can result in hypercalcemia, hyerpercalciuria, and nephrolithiasis, but disease severity is variable. Clinical and biochemical phenotypes were correlated with gene sequence information in a family with two CYP24A1 mutations. A gene dose effect was apparent with monoallelic mutations demonstrating milder disease manifestations than biallelic mutations.

INTRODUCTION

The objective was to examine the spectrum of clinical and biochemical phenotypes in a family with monoallelic and biallelic mutations of CYP24A1 after identification of the proband with two mutations of the CYP24A1 gene: (A) p.R396W and (B) E143del-Het.

METHODS

Clinical and biochemical phenotypes were correlated with CYP24A1 sequence information in the proband and four siblings, a daughter, and two nieces of the proband. The subjects' medical histories were evaluated, and measurement of serum minerals, vitamin D metabolites, PTH, bone turnover markers, and urinary calcium and sequencing of the CYP24A1 gene were performed.

RESULTS

The proband had nephrolithiasis, osteopenia, hypercalcemia, hypercalciuria, elevated serum 1,25(OH)2D, undetectable 24,25(OH)2D, and inappropriately low PTH concentrations. Two subjects with biallelic (A/B) mutations had nephrolithiasis, marked hypercalciuria (583 ± 127 mg/24 h, mean ± SD), compared with five subjects with monoallelic mutations (A or B) with a urine calcium of 265 ± 85 mg/24 h. Two subjects with monoallelic mutations had nephrolithiasis and one had non-PTH dependent hypercalcemia. Five subjects had high 1,25(OH)2D measurements, including three with monoallelic mutations. The 25OHD/24,25(OH)2D ratio, in subjects with biallelic mutations was 291 versus 19.8 in the subjects with monoallelic mutations.

CONCLUSIONS

In this family, adults with CYP24A1 mutations a gene dose effect is apparent: subjects with biallelic, compound heterozygous mutations (A/B) have a more severe clinical and biochemical phenotype, whereas, subjects with monoallelic mutations demonstrate milder disease manifestations which are not easily characterized through biochemical assessment.

Impact of modular training on tobacco control on the knowledge of health workers in two jurisdictions of northern India

BACKGROUND

National Tobacco Control Programme was launched in India in year 2007-08. It was realized that community health workers can play an important role of agents for positive change to bring down the tobacco morbidity and mortality in the country. Keeping this in view, a health worker guide was developed by the Government of India, Ministry of Health and Family Welfare (GOI) in collaboration with The Union South-East Asia (The Union) in the year 2010. The guide provides the information needed by the most basic level of health workers to effectively address the problem of tobacco use in the community. A modular training was conducted in two jurisdictions in India (namely, Chandigarh and Hamirpur (Himachal Pradesh)) to assess the usefulness of the guide as training material for community health workers in undertaking tobacco control activities at community and village levels.

MATERIALS AND METHODS

A total of 271 participants were trained, which included 133 from Chandigarh and 138 from Hamirpur. The pre and post-training assessment of knowledge of health worker was done.

RESULTS

There was marked increase in post-test scores as compared to the pretest scores. The health workers scoring more than 60% increased from 40% in the pretest to over 80% in the post-test. Only three workers had a post-test score of less than 30% against 54 workers in the pretest.

CONCLUSION

The understanding on tobacco control had increased significantly after the training in each group. It is strongly recommended that such training should be replicated to all community health workers across all the states in India.

Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries

INTRODUCTION

Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high.

METHODS

Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day.

RESULTS

Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P < .001). In over one-quarter of venues where smoking was observed the difference between indoor and outdoor PM2.5 concentrations exceeded 64 µg/m(3).

CONCLUSIONS

This study suggests that low-cost air quality monitoring is a viable method for improving knowledge about environmental SHS and can provide indicative data on compliance with local and national SF legislation in hospitality venues in LMICs.

IMPLICATIONS

Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation.

How compliant are tobacco vendors to india's tobacco control legislation on Ban of advertisments at point of sale? A three jurisdictions review

BACKGROUND

Section 5 of India's tobacco control legislation "Cigarettes and Other Tobacco Products Act (COTPA), 2003"comprehensively prohibits all kinds of tobacco advertisement, promotion and sponsorship (TAPS), but permits advertisments at the point-of-sale (POS) under certain conditions. This provision has been exploited by the tobacco companies to promote their products.

OBJECTIVE

To measure compliance with the provisions of Section 5 of Indian tobacco control legislation (COTPA, 2003) at point of sale.

MATERIALS AND METHODS

A cross-sectional survey using an observation checklist was conducted in 1860 POS across three jurisdictions (Chennai city, District Vadodara and District Mohali) in India.

RESULTS

The most common mode of advertisement of tobacco products was product showcasing (51.1%), followed by dangles (49.6%), stickers (33.8%) and boards (27.1%). More than one fourth of POS were found violating legal provisions for displaying advertisement boards in one or other forms (oversized, extended to full body lenth of POS, displayed brandname/ packshot and promotional messages). Advertisement boards (16.3%) without health warnings were also found and wherever found, more than 90% health warning were not as per the specification in respect to size, font and background color.

CONCLUSIONS

Point of sale advertising is aggressively used by the tobacco industry to promote their products. There is an urgent need of effective implementation of a comprehensive ban on tobacco product advertisement, promotion and sponsorship at point of sale.

Intersubgeneric hybridization between Glycine max and G. tomentella: production of F₁, amphidiploid, BC₁, BC₂, BC₃, and fertile soybean plants

KEY MESSAGE

This paper describes methods for unlocking genetic treasure from wild perennial Glycine species of Australia for soybean improvement. The genetic resources of the ca. 26 species of the genus Glycine subgenus Glycine have not been exploited to broaden the genetic base of soybean (Glycine max; 2n = 40). The objectives of this study were to develop methods for producing F1, amphidiploid, BC1, BC2, BC3, and fertile soybean plants from crosses of soybean and the genus Glycine subgenus Glycine species, in order to utilize the subgenus Glycine germplasm in soybean breeding. Soybean cultivars were hybridized with six accessions of 78-chromosome G. tomentella as well as one accession each of 40-chromosome G. tomentella, G. argyrea and G. latifolia. They were chosen because they exhibit resistance to soybean rust. We were successful in producing fertile soybean from soybean cv. 'Dwight' and 78-chromosome G. tomentella accession PI 441001, while other hybrids were discontinued either at F1 or amphidiploid stage. The F1 seeds aborted prior to reaching maturity, so developing seeds from 19 to 21 day old pods were cultured aseptically in various media formulations. Seed maturation and multiple embryo generation media were developed. F1 plants with shoots and roots (2n = 59) were transplanted to pots in greenhouse. Amphidiploid (2n = 118) plants were backcrossed to 'Dwight'. BC1 (2n = 79) plants were propagated through in vitro and 43 mature BC2F1 seeds were harvested. Fifteen surviving BC2F1 plants were morphologically distinct, sterile, and had chromosome numbers ranging 2n = 56-59. Chromosome numbers of the BC3F1 plants ranged 2n = 40-49. Derived fertile soybeans were first planted in the field in 2008 and are being evaluated for yield, resistance to pathogens and pests and tolerance to salt through material transfer agreement.

Unravelling India's tobacco epidemic--priorities and recommendations for the second round of Global Adult Tobacco Survey (GATS)

The Global Adult Tobacco Survey, or GATS, has proved to be an invaluable tool for policymakers. In India, it highlighted the alarming rates of prevalence of use and risks both nationally and at state level. However, a rapid analysis of GATS-India shows that there are limitations in methods (sampling, questionnaire, measures undertaken to ensure data quality and management), which may impact the estimates of prevalence. This review discusses these potential weaknesses and recommends measures that can be adopted in the next round of surveys to overcome the limitations.

Can vitamin D metabolite measurements facilitate a "treat-to-target" paradigm to guide vitamin D supplementation?

Substantial variability exists in the serum 25(OH)D increase observed in response to vitamin D supplementation. Measurement of circulating cholecalciferol and 24,25(OH)₂D, as indicators of vitamin D absorption and degradation, respectively, account for approximately half of the variation in serum 25(OH)D observed following supplementation.

INTRODUCTION

Vitamin D supplementation produces a variable response in serum 25(OH)D. This variability likely reflects, in part, differences in vitamin D absorption and/or degradation. Despite this variation in response, virtually all expert recommendations endorse a fixed vitamin D supplementation dose, an approach also used in most prospective studies. Such utilization of a single vitamin D dose does not assure attaining any pre-specified target 25(OH)D level, thereby compromising clinical care and prospective supplementation trials. This study begins addressing this weakness by exploring the feasibility of vitamin D metabolite measurements to predict serum 25(OH)D level attained following supplementation.

METHODS

Ninety-one community-dwelling postmenopausal women with baseline 25(OH)D of 10-30 ng/mL received oral vitamin D₃, 2300 or 2500 IU, daily for 4-6 months. Serum 25(OH)D, cholecalciferol (D₃), and 24,25(OH)₂D were measured before and at the end of supplementation to determine if metabolite concentrations allow prediction of the 25(OH)D level attained.

RESULTS

From baseline and follow-up data, we derived a multiple linear regression model predicting posttreatment 25(OH)D as follows: final 25(OH)D = 8.3 + (1.05*initial 25(OH)D) - (7.7*initial 24,25(OH)₂D) + (0.53*final D₃) + (4.2*final 24,25(OH)₂D). This model has an adjusted R(2) = 0.55, thus accounting for approximately half of the observed variance in the final 25(OH)D level.

CONCLUSIONS

The contributions of circulating cholecalciferol and 24,25(OH)₂D to this predictive model can be considered as indicators of intestinal absorption and clearance, respectively. This paradigm requires further study; it may allow efficient "treat-to-25(OH)D-target" strategies useful in optimizing prospective studies and clinical practice.

Smoking trends among women in India: Analysis of nationally representative surveys (1993-2009)

Background:

There is growing concern among policy makers with respect to alarming growth in smoking prevalence among women in the developing countries.

Methods:

Using disaggregated data from five nationally representative surveys: Global Adult Tobacco Survey 2010, National Family Health Survey-III (NFHS-III) 2004–2005, NFHS-II 1998-1999, National Sample Survey (NSS) 52^nd Round 1995–1996, NSS 50^th Round 1993-1994 we analysed female smoking trend from 1993-2009. Tobacco use among females was monitored for almost two decades focusing on gender, literacy, and state-specific trends among respondents aged >15 years.

Results:

Smoking use among women has doubled from 1.4% to 2.9% (P < 0.001) during the period 2005-2010. The prevalence of smoking increased with decrease in per capita State Gross Domestic Product and literacy status for both men and women.

Conclusion:

As the overall smoking prevalence grows, female smoking is growing at a faster rate than smoking among males, which is an emerging concern for tobacco control in India and requires the attention of policymakers.

Evidence for gonadotrophin secretory and steroidogenic abnormalities in brothers of women with polycystic ovary syndrome

STUDY QUESTION

Are there abnormalities in gonadotrophin secretion, adrenal steroidogenesis and/or testicular steroidogenesis in brothers of women with polycystic ovary syndrome (PCOS)?

SUMMARY ANSWER

Brothers of women with PCOS have increased gonadotrophin responses to gonadotrophin releasing hormone (GnRH) agonist stimulation and alterations in adrenal and gonadal steroidogenesis.

WHAT IS KNOWN ALREADY

PCOS is a complex genetic disease. Male as well as female first-degree relatives have reproductive features of the syndrome. We previously reported that brothers of affected women have elevated circulating dehydroepiandrosterone sulfate levels.

STUDY DESIGN, SIZE, DURATION

This was a case-control study performed in 29 non-Hispanic white brothers of 22 women with PCOS and 18 control men.

PARTICIPANTS/MATERIALS, SETTING, METHODS

PCOS brothers and control men were of comparable age, weight and ethnicity. Adrenocorticotrophic hormone (ACTH) and GnRH agonist stimulation tests were performed. Gonadotrophin responses to GnRH agonist as well as changes in precursor-product steroid pairs (delta, Δ) across steroidogenic pathways in response to ACTH and GnRH agonist were examined.

MAIN RESULTS AND THE ROLE OF CHANCE

Basal total (T) levels did not differ, but dehydroepiandrosterone (DHEA) levels (0.13 ± 0.08 brothers versus 0.22 ± 0.09 controls, nmol/l, P = 0.03) were lower in brothers compared with control men. ACTH-stimulated Δ17-hydroxypregnenolone (17Preg)/Δ17-hydroxyprogesterone (17Prog) (7.8 ± 24.2 brothers versus 18.9 ± 21.3 controls, P = 0.04) and ΔDHEA/Δandrostenedione (AD) (0.10 ± 0.05 brothers versus 0.14 ± 0.08 controls, P = 0.04) were lower in brothers than in the controls. GnRH agonist-stimulated Δ17Prog/ΔAD (0.28 ± 8.47 brothers versus 4.79 ± 10.28 controls, P = 0.003) was decreased and luteinizing hormone (38.6 ± 20.6 brothers versus 26.0 ± 9.8 controls, IU/l, P = 0.02), follicle-stimulating hormone (10.2 ± 7.5 brothers versus 4.8 ± 4.1 controls, IU/l P = 0.002), AD (1.7 ± 1.4 brothers versus 0.9 ± 1.5 controls, nmol/l, P = 0.02) and ΔAD/ΔT (0.16 ± 0.14 brothers versus 0.08 ± 0.12 controls, P = 0.005) responses were increased in brothers compared with controls.

LIMITATIONS, REASONS FOR CAUTION

The modest sample size may have limited our ability to observe other possible differences in steroidogenesis between PCOS brothers and control men.

WIDER IMPLICATIONS OF THE FINDINGS

Decreased ACTH-stimulated Δ17Preg/Δ17Prog and ΔDHEA/ΔAD responses suggested increased adrenal 3β-hydroxysteroid dehydrogenase activity in the brothers. Decreased Δ17Prog/ΔAD and increased ΔAD/ΔT responses to GnRH agonist stimulation suggested increased gonadal 17,20-lyase and decreased gonadal 17β-hydroxysteroid dehydrogenase activity in the brothers. Increased LH and FSH responses to GnRH agonist stimulation suggested neuroendocrine alterations in the regulation of gonadotrophin secretion similar to those in their proband sisters. These changes in PCOS brothers may reflect the impact of PCOS susceptibility genes and/or programming effects of the intrauterine environment.

STUDY FUNDING/COMPETING INTERESTS

This research was supported by P50 HD044405 (A.D.), K12 HD055884 (L.C.T.), U54 HD034449 (A.D., R.S.L.) from the National Institute of Child Health and Development. Some hormone assays were performed at the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core that is supported by U54 HD28934 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Partial support for some of the clinical studies was provided by UL1 RR025741 and UL1 TR000150 (Northwestern University Clinical and Translational Sciences Institute) from the National Center for Research Resources, National Institutes of Health, which is now the National Center for Advancing Translational Sciences. The authors have no conflict of interest to declare.

How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys

BACKGROUND

India has been implementing smoke-free legislation since 2008 prohibiting smoking in public places. This study aimed to assess the level of compliance with smoke-free legislation (defined as the presence of no-smoking signage and the absence of active smoking, smoking aids, cigarette butts/bidi ends and smoking smell) and the role of enforcement systems in Indian jurisdictions.

METHODS

This was a cross-sectional, retrospective review of reports and primary data sheets of surveys conducted in 38 selected jurisdictions across India in 2012-2013.

RESULTS

Of 20 455 public places (in 38 jurisdictions), 10 377 (51%) demonstrated full compliance with smoke-free law. Educational institutions and healthcare facilities performed well at 65% and 62%, respectively, while eateries and frequently visited other public places (such as bus stands, railway stations, shopping malls, stadia, cinema halls etc.) performed poorly at 37% and 27%, respectively. Absence of no-smoking signage was the largest contributor to non-compliance across all types of public places. Enforcement systems were present in all jurisdictions, but no associations could be demonstrated between these and smoke-free compliance.

CONCLUSION

Smoke-free compliance in public places in India was suboptimal and was mainly related to the absence of no-smoking signage. This warrants further pragmatic and innovative ways to improve the situation.

Pharmacokinetics of daily versus monthly vitamin D3 supplementation in non-lactating women

This study compared serum cholecalciferol and 25-hydroxyvitamin D (25(OH)D) concentrations over four weeks in healthy, non-pregnant, non-lactating females aged 18-40 years, who were randomized to oral cholecalciferol 5000 international units (IU) daily for 28 days or a single dose of 150 000 IU. The study was conducted in Rochester, MN in March and April of 2010. We found no difference in mean 25(OH)D between treatment groups on study day 0 or day 28 (P=0.14 and 0.28, respectively). The daily group had 11 more days of detectable serum cholecalciferol than the single-dose group (P<0.001). There was no difference observed in cholecalciferol area under the curve (AUC28) between groups (P=0.49). However, the single-dose group had a significantly greater mean 25(OH)D AUC28 compared with the daily group (P<0.001).

Public opinion about smoking and smoke free legislation in a district of North India

Context: A growing number of cities, districts, counties and states across the globe are going smoke-free. While an Indian national law namely Cigarettes and Other Tobacco Products Act (COTPA) exists since 2003 and aims at protecting all the people in our country; people still smoke in public places. Aim: This study assessed knowledge and perceptions about smoking, SHS and their support for Smoke-free laws among people residing in Mohali district, Punjab. Materials and Methods: This cross-sectional study was conducted in Mohali district of Punjab, India. A sample size of 1600 people was obtained. Probability Proportional to Size technique was used for selecting the number of individuals to be interviewed from each block and also from urban and rural population. Statistical Analysis Used: We estimated proportions and tested for significant differences by residence, smoking status, literacy level and employment level by means of the chi-square statistics. Statistical software SPSS for Windows version 20 was used for analysing data . Results: The overall prevalence of current smoking among study participants was 25%. Around 96% were aware of the fact that smoking is harmful to health, 45% viewed second-hand smoke to be equally harmful as active smoking, 84.2% knew that smoking is prohibited in public places and 88.3% wanted the government to take strict actions to control the menace of public smoking. Multivariate logistic regression analysis showed that people aged 20 years and above, unemployed, urban, literate and non-smokers had significantly better perception towards harms of smoking. The knowledge about smoke free provisions of COTPA was significantly better among males, employed individuals, urban residents, and literate people. Conclusions: There was high knowledge about deleterious multi-dimensional effects of smoking among residents and a high support for implementation of COTPA. Efforts should be taken to make Mohali a "smoke-free district".

Refining compliance surveys to measure the smokefree status of jurisdictions using the Delphi method

SETTING

Compliance assessment surveys are cost-effective means of assessing smokefree status in a jurisdiction. Assigning weights to assessment criteria (indicators) can also inform law implementers and policy makers about the effectiveness of the enforcement of smokefree rules.

OBJECTIVE

To develop a standardised measure for compliance surveys using the Delphi method in India.

DESIGN

Tobacco control experts from India comprising different constituencies and jurisdictions met for a half-day workshop in August 2012 to deliberate on how weights can be assigned to criteria for smokefree status. Using the Delphi method, the relevance and ranking of criteria from an existing protocol for measuring compliance was evaluated.

RESULTS

Consensus was reached on all five compliance survey indicators through three rigorous rounds of discussion. The highest priority was assigned to the absence of the act of smoking in public places (33%), followed by the display of no-smoking signage in public places (32%), absence of cigarette butts or bidi stubs (15%), absence of smoking aids (10%) and absence of tobacco smoke and ash (10%).

CONCLUSION

Tobacco control advocates can effectively inform local policy makers using weights that prioritise directed enforcement and targeted interventions, which in turn will ensure stronger compliance and sustainable smokefree settings.

Assessing compliance to smoke-free legislation: results of a sub-national survey in Himachal Pradesh, India

INTRODUCTION

Exposure to second-hand smoke (SHS) is a serious public health concern. The Indian smoke-free legislation 'Prohibition of Smoking in Public Places Rules, 2008' prohibits smoking in public places, including workplaces.

OBJECTIVE

To measure the status of compliance to legal provisions that protects the public against harms of SHS exposure, identifies the potential areas of violations and informs policy makers for strengthening enforcement measures.

DESIGN

A cross-sectional survey in 1401 public places across 11 district headquarters in Himachal Pradesh, India, using a compliance guide developed by partners of the Bloomberg initiatives to reduce tobacco use.

RESULTS

In 1401 public places across 11 district headquarters, 42.8% public places had signage; in 84.2% public places, no smoking was observed and in 83.7%, there was absence of smoking accessories such as ashtray, matchbox and lighter . Tobacco litter like cigarette butts was absent in 64.7% of the public places. Overall, at the state level, there was more than 80% compliance on at least three of the five indicators. Among all categories of public places, educational institutions and offices demonstrated highest compliance, whereas most frequently visited public places, eateries and accommodation facilities had least compliance.

CONCLUSIONS

The compliance to 'Prohibition of Smoking in Public Places Rules, 2008' was variable in various district headquarters of Himachal Pradesh. This study identified the potential areas of violations that need attention from enforcement agencies and policymakers.

Promoting tobacco cessation by integrating 'brief advice' in tuberculosis control programme

BACKGROUND

There is an enormous health burden caused by the co-prevalence of tuberculosis (TB) and tobacco use in India. This intervention study was undertaken in district Vadodara, Gujarat, India to promote tobacco cessation by integrating 'brief advice' for tobacco cessation in TB patients who were tobacco users and registered for treatment under TB control programme, based on the tested strategies advocated by World Health Organization (WHO) and the International Union against Tuberculosis and Lung Diseases (The Union).

MATERIALS AND METHODS

Brief advice for tobacco cessation based on five A's, advocated by the WHO and the UNION was incorporated into the on-going TB Control programme in India in the year 2010. The tools were developed for education, training and capturing data. All the registered TB patients receiving directly observed treatment short-course (DOTS) who used tobacco in any form were offered brief advice during routine interaction for treatment.

RESULTS

A total of 46.3% of TB patients, predominantly males (89.6% males and 10.3% females) were current users of tobacco; 39.1% used smokeless tobacco, 35.9% were smokers and 25% were dual users, that is, smoked as well as used smokeless tobacco. At the end of treatment, of the 67.3% patients who were offered brief advice, quit tobacco use, 18.2% re-lapsed while 14.5% were lost to follow-up.

CONCLUSION

A significant numbers of TB patients use tobacco with adverse impact on TB control programmes. Our study shows that it is feasible to introduce 'brief advice' strategy as a cost effective intervention for tobacco cessation among TB patients with careful monitoring.

Genomic diversity and multiple origins of tetraploid (2n = 78, 80) Glycine tomentella

Among 15 wild perennial species of the genus Glycine Willd. subgenus Glycine, G. tomentella is exceptional. It is composed of four cytotypes (2n = 38, 40, 78, 80), is diverse in morphological features, and covers a wide geographical area. The objectives of this study were to uncover the genomic diversity in 78- and 80-chromosome cytotypes through a multidisciplinary approach, using cytogenetic, biochemical, and molecular methods, to verify previously identified isozyme groupings and to determine their possible origins. The cytogenetic observations, total seed protein and protease inhibitor profile comparisons, and the phylogenetic analysis of restriction fragment length polymorphisms identified three distinct groups (T1, T5, T6) among aneutetraploid (2n = 78) and four distinct groups (T2, T3, T4, T7) among tetraploid (2n = 80) G. tomentella accessions. The groupings were congruent with those of isozyme analysis. Tetraploid accessions from Indonesia were assigned to a new group, T7, based on the present study. Morphology, cytology, and seed protein banding patterns of synthetic tetraploids indicated that the T1 and T5 group aneutetraploids were composed of D3D3EE and AAEE genomes, respectively, and the T2 group tetraploid accessions consisted of AAD3D3 genomes. Various groups within the 78- and 80-chromosome G. tomentella were suggested to have originated in Australia by allopolyploidization, most likely through multiple independent events.

Occupational stress and social support in naval personnel

BACKGROUND

Data show that naval personnel have a high incidence of stress related disorders. A high prevalence of occupational stress was seen in a previous survey carried out on Indian Naval personnel. However, the role of social support in reducing occupational stress was not studied. To study occupational stress in Indian Naval personnel and to study the effect of social support on occupational stress.

METHODS

5077 naval personnel were surveyed using study questionnaires which included Occupational Stress Inventory, Multidimensional Scale of Perceived Social Support, and the General Health Questionnaire (GHQ)-12 item version as a measure of psychological health. The data was statistically analysed using chi square test and other non-parametric tests.

RESULTS

High occupational stress was seen in personnel serving afloat (66.47%) as compared to those serving ashore (51.55%) and on submarines (53.72%). Among personnel serving afloat, occupational stress was highest among Junior Sailors as compared to Senior Sailors and Officers. Occupational stress was linked to poor psychological health as measured by the GHQ and younger age. Perceived social support was effective in reducing occupational stress in Officers and Senior Sailors but not in Junior Sailors where paradoxically it seemed to lead to greater occupational stress.

CONCLUSIONS

High occupational stress was seen in more than half the service personnel studied. Occupational stress is mitigated by social support in Officers and Senior Sailors but not in Junior Sailors.

Second-hand smoke: a neglected public health challenge

Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

Compliance surveys: an effective tool to validate smoke-free public places in four jurisdictions in India

Smoke-free initiatives have gained significant momentum since India enacted comprehensive smoke-free legislation in October 2008. The International Union Against Tuberculosis and Lung Disease has actively supported various levels of government, legislators, civil society, and communities across the country to implement smoke-free public places and comply with the law. On World No Tobacco Day 2010, four jurisdictions demonstrated that public places within their jurisdictions were smoke-free. These jurisdictions cover a wide spectrum of demographic and geographic variation and include an entire state. The demonstration of being 'smoke-free' in these jurisdictions was supported by a simple survey that documented compliance with the smoke-free law in the country.

Diagnostic characteristics of late-night salivary cortisol using liquid chromatography-tandem mass spectrometry

OBJECTIVE

The objective of the study was to describe the diagnostic performance of a commercially available late-night salivary cortisol (NSC) assay using liquid chromatography tandem mass spectrometry.

METHODS

We retrospectively identified 90 patients who had one or more NSC determinations: 52 patients in whom Cushing syndrome (CS) was excluded or could not be confirmed [group 1 (G1)] and 38 patients in whom CS was confirmed [group 2 (G2)]. Eighteen healthy volunteers served as controls.

RESULTS

Baseline demographics in all groups were similar with regards to age, ethnicity, gender, and body mass index. NSC levels [median (range)] were higher in G2, 381 (64-13,500) ng/dl [10.51 (1.77-372.46) nmol/liter], compared with controls, 19.3 (2.1-416) ng/dl [0.53 (0.06-11.48) nmol/liter], and G1, 26 (4-176) ng/dl [0.72 (0.11-4.86) nmol/liter, P < 0.001]. The highest combined sensitivity (92%) and specificity (92%) was achieved at a cut point of 107 ng/dl (2.95 nmol/liter). Two or more NSCs were done in 32 of 52 G1 and 31 of 38 G2 patients. In G1 eight of 32 (25%) had at least one elevated [>100 ng/dl (2.76 nmol/liter)] NSC including two in whom both NSCs were elevated. In contrast, four of 31 (13%) in G2 had at least one normal NSC including one with four of five normal NSC values. None of the patients with CS had a NSC less than 60 ng/dl (<1.66 nmol/liter). Comparing G1 and G2, obtaining more than one saliva sample did not improve the diagnostic accuracy of NSC measurement (P = 0.64).

CONCLUSION

The liquid chromatography tandem mass spectrometry assay to measure NSC is a simple and reliable test to screen patients suspected to have CS. Clinicians should be aware of appropriate cutoff values for proper interpretation of NSC and use additional tests when necessary.

Vitamin D status and longitudinal lung function decline in the Lung Health Study

Low blood vitamin D levels have been postulated to be a risk factor for worse lung function, based largely on cross-sectional data. We sought to use longitudinal data to test the hypothesis that baseline plasma 25-hydroxyvitamin D (25(OH)D) is lower in subjects with more rapid lung function decline, compared to those with slow lung function decline. We conducted a nested, matched case-control study in the Lung Health Study 3 cohort. Cases and controls were continuous smokers with rapid and slow lung function decline, respectively, over ~6 yrs of follow-up. We compared baseline 25(OH)D levels between cases and controls, matching date of phlebotomy and clinical centre. Among 196 subjects, despite rapid and slow decliners experiencing strikingly and significantly different rates of decline of forced expiratory volume in 1 s (-152 versus -0.3 mL·yr⁻¹; p < 0.001), there was no significant difference in baseline 25(OH)D levels (25.0 versus 25.9 ng·mL⁻¹; p = 0.54). There was a high prevalence of vitamin D insufficiency (35%) and deficiency (31%); only 4% had a normal 25(OH)D level in the winter. Although vitamin D insufficiency and deficiency are common among continuous smokers with established mild-to-moderate chronic obstructive pulmonary disease, baseline 25(OH)D levels are not predictive of subsequent lung function decline.

Primary trisomics of rice: origin, morphology, cytology and use in linkage mapping

Twelve primary trisomics of Oryza sativa L. were isolated from the progenies of spontaneous triploids and were transferred by backcrossing to the genetic background of IR36, a widely grown high yielding rice variety. Eleven trisomics can be identified morphologically from one another and from diploids. However, triplo 11 is difficult to distinguish from diploid sibs.-The extra chromosome of each trisomic was identified cytologically at pachytene stage of meiosis, and the chromosomes were numbered according to their length at this stage. The major distinguishing features of each pachytene chromosome were redescribed.-The female transmission rates varied from 15.5% for triplo 1, the longest chromosome, to 43.9% for triplo 12, the shortest chromosome. Seven of the 12 primary trisomics transmitted the extra chromosome through the male. The low level of chromosomal imbalance tolerated by rice and other evidence are interpreted to indicate that this species is a basic diploid.-Genetic segregation for 22 marker genes in the trisomic progenies was studied. Of a possible 264 combinations, involving 22 genes and 12 trisomics, 120 were examined. Marker genes for each of the 12 chromosomes were identified. The results helped establish associations between linkage groups and cytologically identifiable chromosomes of rice for the first time. Relationships between various systems of numbering chromosomes, trisomics, linkage groups and marker genes are described, and a revised linkage map of rice is presented.

Comparison of sex steroid measurements in men by immunoassay versus mass spectroscopy and relationships with cortical and trabecular volumetric bone mineral density

In men, measurement of serum testosterone and estradiol levels with immunoassays correlated with mass spectroscopic measurements, and correlations of sex steroids with volumetric bone mineral density were similar.

INTRODUCTION

While immunoassays have been used extensively for measurement of serum testosterone (T) and estradiol (E(2)) levels, there is concern about their specificity, particularly at low E(2) levels as present in men.

METHODS

We compared T and E(2) measured by mass spectroscopy to levels measured by immunoassay in men (n = 313, age 22 to 91 years) and related these to volumetric bone mineral density (vBMD) at various skeletal sites.

RESULTS

Serum T and non-SHBG bound (or bioavailable) T levels by immunoassay correlated well with the corresponding mass spectroscopy measurements (R = 0.90 and 0.95, respectively, P < 0.001); the correlations for serum E(2) measured using the two techniques were less robust (R = 0.63 for total E(2) and 0.84 for bioavailable E(2), P < 0.001). Overall relationships between serum bioavailable T and E(2) levels with vBMD at various skeletal sites were similar for the immunoassay and mass spectroscopic measures.

CONCLUSIONS

Although E(2) levels with immunoassay correlate less well with the mass spectroscopic measurements than do the T measurements in men, our findings indicate that the fundamental relationships observed previously between vBMD and the sex steroids by immunoassay are also present with the mass spectroscopic measurements.

Processing of rayon waste effluent for the recovery of zinc and separation of calcium using thiophosphinic extractant

Zinc is used in various metallurgical, chemical and textile industries. In textile industries, waste effluent containing zinc is generated during the manufacture of rayon yarn. Due to the strict environmental regulations and the presence of toxic metallic and other constituents, the discharge of effluents in sewage is restricted. In view of above a process has been developed for the recovery of zinc from rayon waste effluent following solvent extraction technique using thiophosphinic extractants Cyanex 272 and 302. Before recycling of zinc sulphate solution in spinning bath, solution must be free from calcium, which is deleterious to the process as gypsum precipitates and forms scale. The extractant Cyanex 302 has been found selective for the recovery of 99.99% of zinc in the form of [R(2)Zn](org) from the effluent above equilibrium pH 3.4 maintaining the O/A ratio of 1/30 leaving all the calcium in the raffinate. The zinc from the loaded Cyanex 302 can be stripped with 10% sulphuric acid at even O/A ratio of 10. The stripped solution thus obtained could be recycled in the spinning bath of the rayon plant and raffinate could be disposed safely without affecting environment.