Real time-polymerase chain reaction (RT-PCR) is used routinely in clinical practice as a cost-effective method for molecular diagnostics. Research in pediatric B-cell Acute Lymphoblastic Leukemia (ped B-ALL) suggests that apart from cytogenetics and clinical features, there is a need to include Copy number variation (CNV) in select genes at diagnosis, for upfront stratification of patients. Using ped B-ALL as a model, we have developed a RT-PCR-based iterative probability scoring method for reporting CNVs, and relative gene-expression changes. Our work highlights that once genes of interest and hotspots of CNVs are identified in discovery phase, our proposed method can be used as a cost-effective and user-friendly diagnostic tool for the identification of changes at genomic or transcriptomic level. It has the potential to be incorporated in routine diagnostics in resource constrained settings and be tailored for different diseases as per need.

Training caregivers performing PD is an important measure to prevent peritonitis. A low literacy rate hinders training in low-resource settings. We designed a structured training initiative (STI) and objective structured assessment (OSA) using visual and kinesthetic resources with minimal use of written resources. We studied the impact of STIs on caregivers’ knowledge and practical skills and the rate of peritonitis. This prospective study conducted initial STI (iSTI) for caregivers of children initiating PD and retraining STI (rSTI) for those already on PD. OSA was administered after completion of training, and those scoring < 95

Theoretical models of non-suicidal self-injury (NSSI) have highlighted the complex interaction between underlying psychosocial vulnerabilities, but, there is limited empirical support for these conceptualizations. The aim of the study was to examine affective, cognitive and interpersonal factors predicting NSSI among emerging adults. A sample of 1,574 emerging adults aged 18-25 years, drawn from 19 colleges via multi-stage sampling completed measures of NSSI, emotion regulation, experiential avoidance, psychological distress, self-criticism, brooding-rumination, attachment style and perceived social support. The results indicated that 22.40% had engaged in one or more self-injuring behaviours in the past 12 months, with cutting skin, hitting self and severely scratching self as the most commonly endorsed methods. Exploratory structural equation modelling identified differential pathways to NSSI, with difficulties in regulating emotions emerging as the only direct predictor of NSSI. Two latent constructs reflecting relationally based affective and cognitive structures: a negative self-other representation, and attachment style of considering relationships as secondary to achievement were identified. These differentially, and indirectly impacted NSSI engagement through psychological distress and difficulties in emotion regulation. The implications for interventions to expand beyond addressing emotion regulation deficits, and include other affective, cognitive and relational vulnerabilities are discussed.

Background The COVID-19 pandemic disrupted livelihoods and diets across the world. This study aimed to assess changes in household diet diversity and food consumption between the pre-COVID-19 period (December 2019–January 2020) and during the lockdown (March–May 2020), and to identify the socio-economic characteristics that determine these changes in rural Bihar, India. Methods Households that had provided their phone numbers in the pre-COVID-19 household survey ( n = 1797) were contacted for interviews during the lockdown telephonic survey in a longitudinal survey in two districts (Gaya and Nalanda) in Bihar. In total, 939 households were interviewed. Using data on food consumption from both surveys, 876 households were included in the analysis. Food and Agriculture Organization’s household diet diversity score (HDDS) was used to compare diet diversity between the pre-COVID-19 period and during the lockdown. Logistic regression was used to identify factors affecting household diet diversity and food consumption in the study households. Results Low diet diversity increased from 51.6% (95% CI 48.3–54.9) to 75.8% (95% CI 73.0–78.6) from the pre-COVID-19 to the lockdown period. Reduced food consumption was reported across all foods with nearly a quarter of the households reporting reduced consumption of fruits (27%), pulses (25%) and cereals (21%). Nearly 60% and above reported stopping consumption of nutrient-rich foods such as chicken, fish and eggs although the population was predominantly non-vegetarian. Logistic regression analysis revealed that taking a loan from neighbours/relatives (OR = 1.8; 95% CI 1.3–2.5) and belonging to lower social groups (OR = 1.8; 95% CI 1.1–2.9) increased odds of low HDDS. While those possessing ration cards had lower odds of reduced consumption of all food items, it was not associated with stopping consumption of any food item. In an unadjusted analysis, receipt of cash transfer during lockdown was also not associated with diet diversity (OR = 1.2; 95% CI 0.9–1.7). Conclusions COVID-19 has impacted the consumption of nutrient-rich foods among already low-income rural households in India. Maintaining diet diversity among socio-economically vulnerable households during periods when food consumption is most threatened by shocks such as COVID-19 would need sustained government support in terms of social protection coverage and benefit transfers in rural communities.

BACKGROUND:There is a need for empirical evidence on changes in employment and food consumption during pandemic situations in households belonging to the informal economy. OBJECTIVE:To examine changes in food insecurity, household diet diversity, and employment in agriculture during the pre-COVID-19 (2019-early 2020) and COVID-19 pandemic (September 2021) periods. METHODS:A total of 1632 households from a face-to-face pre-COVID-19 survey and 621 of those followed up by a telephonic survey during COVID-19 in Bihar, India, were included in the analyses. Household food insecurity, household diet diversity score (HDDS), and employment change (agriculture or nonagriculture) were assessed during both periods. Food insecurity and diet diversity in the 2 periods were examined by logistic regression. A change in the odds of being food insecure or having low HDDS was examined as an interaction between time and employment status. RESULTS:Prevalence of food insecurity increased from 21% to 55%, and low diet diversity increased from 47% to 69% in households assessed in both surveys. Employment status was not associated with food insecurity or low HDDS during the baseline survey. However, during the pandemic, ∼30% of households changed their employment from agriculture to nonagriculture and were more likely to be food insecure (adjusted odds ratio [aOR]: 2.77; 95% confidence interval [CI] 1. 78-4.32) and have low HDDS (aOR: 1.66; 95%CI: 1.05-2.61), than those who remained in agriculture. Similarly, those who retained nonagricultural employment during the pandemic were more likely to be food insecure (aOR: 2.23; 95%CI: 1.45-3.43) and have low HDDS (aOR: 1.73; 95%CI: 1.11-2.70), compared to those who remained in agriculture. In propensity score-adjusted interaction analysis of time and employment, food insecurity and low HDDS remained significantly associated with nonagricultural employment during the pandemic. CONCLUSIONS:Enhanced support to rural households in agricultural occupations could buffer them from unexpected crises, which may also protect their nutritional intake.

BACKGROUND:The current estimates of energy and protein to bridge nutrient gap in the beneficiaries of the Integrated Child Development Services (ICDS) supplementary nutrition program use sub-optimal methodology for deficit calculation.OBJECTIVE:To estimate the nutrient deficit and the risk of inadequate nutrient intake in beneficiaries of the ICDS, aged 6-36 months, using individual 24-hour diet recalls, from districts of Chitradurga and Davanagere in Karnataka.STUDY DESIGN:Cross-sectional design.PARTICIPANTS:Children (aged 6 to 36 months) registered as beneficiaries of the ICDS in these districts.METHODS:Data were collected on socio-demographic factors, child feeding patterns, perception and usage of take home ration (THR), between August to October, 2019. Three non-consecutive days' 24-hour diet recall data of children were obtained from mothers, and anthropometric measurements were taken. The proportion of children at risk of inadequate nutrient intakes was estimated using the probability approach. Assuming that 50% of a healthy population will be at risk of nutrient inadequacy such that intake and requirement distributions overlap, the proportion at actual risk of nutrient inadequacy (≥50%) was calculated.RESULTS:A combined district analysis showed a median energy deficit of 109 kcal and 161 kcal in children belonging to the age groups of 6-12 month and 13-36 month, respectively. The actual risk of inadequate intake for both age groups ranged between 12-47% for fat and other micronutrient (iron, calcium, zinc, folate, vitamin B12 and vitamin A), despite breastfeeding, complementary feeding and reported THR use.CONCLUSION:Children who receive supplementary nutrition as part of the national program fail to meet their nutrient requirements that are essential for growth and development. The study results may help in strengthening the IYCF counselling and in modification of the existing THR, with quality and cost implications.

Background: High prevalence rates and variations in patterns of non-suicidal self-injury (NSSI) necessitate the identification of profiles of distinct sub-groups of self-injurers. Aim: To identify homogenous sub-groups of NSSI in a community-based sample of emerging adults. Method: Data was collected using a cross-sectional survey design from a sample of 1,574 emerging adults aged 18-25 years, via multi-stage sampling. Cluster analysis using the k-medoid partitioning method was used to identify homogenous sub-groups in the sub-sample of 353 selfinjurers. Follow-up analysis was conducted on measures of self-criticism, brooding-rumination, emotion regulation difficulties, experiential avoidance, psychological distress, attachment style and perceived social support to explore the validity of the clusters. Results: Five homogenous sub-groups were identified; Multimethod, Exclusively Severe, Female Minor, Male Minor and Experimental NSSI. The sub-groups showed distinct patterns of NSSI behaviour, differing on the basis of gender, severity, frequency, diversification, age of onset and functions of NSSI. The Multimethod and Exclusively severe NSSI group members showed significantly higher psychological distress and emotion regulation difficulties. Conclusion: Identification of distinct sub-groups highlights the heterogeneity in NSSI behaviour. This has implications for comprehensive assessment frameworks, early identification of more vulnerable groups of self-injurers, and planning of targeted interventions.

Background: Aggregation of tau into paired helical filament (PHF) is a hallmark of Alzheimer's disease (AD), and Cys-mediated disulfide bond formation plays a vital role in tau fibrillation. While intermolecular disulfide bond between Cys residues in microtubule-binding repeat (MTBR) region facilitates tau aggregation, intramolecular disulfide bond attenuates the same, though the molecular basis for such phenomenon remains obscure. Thus intramolecular disulfide-bonded tau monomer might be an excellent model to understand the unique features of aggregation-resistant tau conformer. Methods: We synthesized the Cys cross-linked tau40 monomer by oxidation and characterized the altered conformational dynamics in the molecule by Hydrogen-deuterium exchange, limited proteolysis and fluorescence quenching. Results: Deuterium exchange study showed that rigidity was imparted in the core PHF region of oxidized tau40 in MTBR segment, consisting of the fundamental PHF6 motif. Conformational rigidity was prominent in C-terminal tail region also. Limited proteolysis supported reduced accessibility of MTBR region in the molecule. Conclusions: PHF formation of oxidized tau40 might be attenuated either by induction of intramolecular H-bonding between the regions of high beta-structure propensity in second and third MTBR (R-2, R-3), thus preventing intermolecular interaction between them, or by imparted rigidity in R-2-R-3, preventing the formation of extended beta-structure preceding fibrillation. Data indicated plausible effect of conformational adaptation on the nucleation process of oxidized tau40 assembly. General significance: Our findings unravel the essential molecular features of aggregation-resistant tau conformer. Therapeutics stabilizing such conformers in vivo might be of high benefit in arresting tau assembly during AD and other tauopathies.