Research in urban ecology is growing rapidly in response to the exponential growth of the urban environment. However, few studies have focused on tropical megacities, and on the interplay between predators' habitat selection and human socio-economic aspects, which may mediate their resilience and coexistence with humans. We examined mechanisms of breeding habitat selection by a synanthropic raptor, the Black Kite Milvus migrans, in Delhi (India) where kites mainly subsist on: (1) human refuse and its associated prey-fauna, and (2) ritualised feeding of kites, particularly practised by Muslims. We used mixed effects models to test the effect of urban habitat configuration and human practices on habitat selection, site occupancy and breeding success. Kite habitat decisions, territory occupancy and breeding success were tightly enmeshed with human activities: kites preferred areas with high human density, poor waste management and a road configuration that facilitated better access to resources provided by humans, in particular to Muslim colonies that provided ritual subsidies. Furthermore, kites bred at 'clean' sites with less human refuse only when close to Muslim colonies, suggesting that the proximity to ritual-feeding sites modulated the suitability of other habitats. Rather than a nuisance to avoid, as previously portrayed, humans were a keenly-targeted foraging resource, which tied a predator's distribution to human activities, politics, history, socio-economics and urban planning at multiple spatio-temporal scales. Many synurbic species may exploit humans in more subtle and direct ways than was previously assumed, but uncovering them will require greater integration of human socio-cultural estimates in urban ecological research.

Remote technologies are producing leapfrog advances in identifying the routes and connectivity of migratory species, which are still unknown for hundreds of taxa, especially Asian ones. Here, we used GPS-telemetry to uncover the migration routes and breeding areas of the massive population of migratory Black-eared kites wintering around the megacity of Delhi-India, which hosts the largest raptor concentration of the world. Kites migrated for 3300–4800 km along a narrow corridor, crossing the Himalayas at extremely high elevations (up to > 6500 m a.s.l.) by the K2 of the Karakoram Range and travelled long periods at elevations above 3500 m. They then crossed/circumvented the Taklamakan Desert and Tian Shan Range to reach their unknown breeding quarters at the intersection between Kazakhstan, Russia, China and Mongolia. Route configuration seemed to be shaped by dominant wind support and barrier avoidance. Wintering ranges were smaller than breeding ranges and concentrated around Delhi, likely in response to massive human food-subsidies. Our results illustrate that high-elevation crossings by soaring migrants may be more common than previously appreciated and suggest the delineation of a hitherto poorly-appreciated “Central Asian Flyway”, which must funnel hundreds of thousands of migrants from central Asia into the Indian subcontinent via multiple modes of the Himalayan crossing.

IMPORTANCE Hypertension is very common, but guideline recommendations for hypertension have been controversial, are of increasing interest, and have profound implications. OBJECTIVE To systematically assess the consistency of recommendations regarding hypertension management across clinical practice guidelines (CPGs). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of hypertension management recommendations included CPGs that had been published as of April 2018. Two point-of-care resources that provided graded recommendations were included for secondary analyses. Discrete and unambiguous specifications of the population, intervention, and comparison states were used to define a series of reference recommendations. Three raters reached consensus on coding the direction and strength of each recommendation made by each CPG. Three independent raters reached consensus on the importance of each reference recommendation. MAIN OUTCOMES AND MEASURES The main outcomes were rates of consistency for direction and strength among CPGs. Sensitivity analyses testing the robustness were conducted by excluding recommendation statements that were described as insufficient evidence, excluding single recommendation sources, and stratifying by importance of recommendations. RESULTS The analysis included 8 CPGs with a total of 71 reference recommendations, 68 of which had clear recommendations from 2 or more CPGs. Across CPGs, 22 recommendations (32%) were consistent in direction and strength, 18 recommendations (27%) were consistent in direction but inconsistent in strength, and 28 recommendations (41%) were inconsistent in direction. The rate of consistency was lower in secondary analyses. When insufficient evidence ratings were excluded, there was still substantial inconsistency, and a leave-one-out sensitivity analysis suggested the inconsistency could not be attributed to any single recommendation source. Inconsistency in direction was more common for recommendations deemed to be of lower importance (11 of 20 recommendations [55%]), but 17 of 48 high-importance recommendations (35%) had inconsistency in direction. CONCLUSIONS AND RELEVANCE Hypertension is a common chronic condition with widespread expectations surrounding guideline-based care, yet CPGs have a high rate of inconsistency. Further investigations should determine the reasons for inconsistency, the implications for recommendation development, and the role of synthesis across recommendations for optimal guidance of clinical care.

Human socio-cultural factors are recognized as fundamental drivers of urban ecological processes, but their effect on wildlife is still poorly known. In particular, human cultural aspects may differ substantially between the extensively studied urban settings of temperate regions and the poorly studied cities of the tropics, which may offer profoundly different niches for urban wildlife. Here, we report how the population levels of a scavenging raptor which breeds in the megacity of Delhi, the black kite Milvus migrans , depend on spatial variation in human subsidies, mainly in the form of philanthropic offerings of meat given for religious purposes. This tight connection with human culture, which generated the largest raptor concentration in the world, was modulated further by breeding-site availability. The latter constrained the level of resource-tracking by the kites and their potential ecosystem service, and could be used as a density-management tool. Similar ties between animal population densities, key anthropogenic resources and human beliefs may occur in thousands of cities all over the globe and may fit poorly with our current understanding of urban ecosystem functioning. For many urban animals, key resources are inextricably linked with human culture, an aspect that has been largely overlooked.

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INTRODUCTION: Pelvic inammatory disease (PID) comprises a spectrum of inammatory disorders of the upper female genital tract, including any combination of endometritis, salpingitis, Tubo-ovarian abscess, and pelvic peritonitis. The CDC has estimated that more than I Million women experience an episode of PID every year. Studies have reported prevalence ranging from 5.2% to 17.2% PID in various parts of India. Ultrasound:- TAS was initially used followed by use of TVS with Doppler in diagnosis of PID, although there are no large studies evaluating its sensitivity and or overall usefulness. Itis a frequentlyordered study in patients with classic symptoms of PID or who have unexplained, acute pelvic pain. MATERIAL AND METHODS:A retrospective analysis of medical records of patients with a complaint of lower abdominal pain was included in the study. Diagnosis of PID was made and patient was followed in the outdoor clinic. Pelvic examination was made. USG was done. According to symptoms and clinical examination for PID patients, the data was recorded. Medical record of 120 patients from 1 January 2020 to 31 May 2021 from a private clinic in Dist. Shivpuri were studied. RESULTS: In our study out of 120 cases, most of the patients 50.83% belonged to 26-30 years of age, a maximum number of patients were rural 83.33%. Most of the patients were educated below HSC 56.66%. Most of them 85% were married and most of them were multipara 56.66%. The most common presenting complaint was a pain in the abdomen (100%), followed by per vaginal discharge (65%), pain in the lower back (43.33%), abnormal uterine bleeding (40%), dysmenorrhoea (31.66%), dyspareunia (24.16), fever (17.5%) and others. On clinical examination abnormal PV discharge was present in 61.66% of cases, xed and retroverted uterus with or without thickend appendages were found in 55% of cases. Cervical motion tenderness was found in 78.33% of cases. Adnexal tenderness was found in 80% of cases but adnexal mass was found in 10.83% of cases. The most common nding on ultrasound scan was uid in the pouch of douglas 48.33%, followed by distal hydrosalphinx 28.33%, endometritis 18.33%, pyosalpinx 15%, TO Mass 13.33% and Pelvic collection in 10.83% of cases. CONCLUSION:The focus of this study was to identied socio-demographic characteristics of PID, to see the variety of presenting complaints and pelvic examination ndings and to correlate the clinical ndings with the USG ndings of PID. Much studies about the sensitivity & specicity of USG are not available, but this is denitely the most frequently ordered investigation in cases of PID. Transabdominal ndings of 'incomplete septa' 'cog wheel' 'beads on a strings' signs helps in distinguishing a dilated fallopian tube from other cystic adnexal masses To prevent long term sequelae PID should be the part of differential diagnosis in all patients aged 15-44 year with non specic abdominal pain.

Correlations in the timings of vulture collapse and rapid urbanisation in South Asia have affected the benefit trade-offs concerning conservation-breeding for vulture restoration. We show how the loss of vultures 30 years ago has led to the extinction of experience amongst people in South Asia who are co-adapted to various animal species within shared landscapes. We conducted ethnography that focused on avian scavengers (vultures, kites and crows) in Delhi to unpack how salience and charisma for avian scavengers link with socio-cultural legends. Perceptions about avian scavengers were based on birds’ appearance, behaviour, and ecosystem services. Anthropomorphisation mediated human-animal co-adaptation and drove ritual feeding of commensals that opportunistically consume garbage. Conflated with ethnoecology, such human-constructed niches supported enormous animal populations in the region and drove mutual tolerance. Prior evaluations of scavengers’ niche from biophysical perspectives alone have, therefore, overlooked links between vultures and animal husbandry practices. It undermined competitive release on commensals that have responded by an increase in numbers and distribution, by taking advantage of ritual feeding and people’s affiliative attitudes. The absence of vultures limits the availability of spaces where animal husbandry can be practised. Conversely, expanding built-up spaces, overhead wires, fake news, and interference from competing scavengers will be impediments to vulture restoration. Conservation policies should examine immediate and long-term objectives of solid waste disposal, considering the odds against the attainment of the yesteryear functional ecology of vultures in South Asia. We conclude that wildlife restoration in urbanising tropical landscapes is a moving target, necessitating policies sensitive to progressive loss and/or changes in associative heritage due to shifting economic and cultural practices.