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Managing clinical trials is a complex process requiring careful integration of human, technology, compliance, and operations for success. We collaborated with experts to develop a multi-axial Clinical Trials Management Ecosystem (CTME) maturity model (MM) to help institutions identify best practices for CTME capabilities.
Methods:
A working group of research informaticists was established. An online session on maturity models was hosted, followed by a review of the candidate domain axes and finalization of the axes. Next, maturity level attributes were defined for min/max levels (level 1 and level 5) for each axis of the CTME MM, followed by the intermediate levels. A REDCap survey comprising the model’s statements was then created, and a subset of working group members tested the model by completing it at their respective institutions. The finalized survey was distributed to all working group members.
Results:
We developed a CTME MM comprising five maturity levels across 11 axes: study management, regulatory and audit management, financial management, investigational product management, subject identification and recruitment, subject management, data, reporting analytics & dashboard, system integration and interfaces, staff training & personnel management, and organizational maturity and culture. Informaticists at 22 Clinical and Translational Science Award hubs and one other organization self-assessed their institutional CTME maturity. Respondents reported relatively high maturity for study management and investigational product management. The reporting analytics & dashboard axis was the least mature.
Conclusion:
The CTME MM provides a framework to research organizations to evaluate their current clinical trials management maturity across 11 axes and identify areas for future growth.
Academic-community research partnerships focusing on addressing the social determinants of health and reducing health disparities have grown substantially in the last three decades. Early-stage investigators (ESIs), however, are less likely to receive grant funding from organizations like the National Institutes of Health, and we know little about the facilitators and barriers they face on their career journeys or the best ways to support them and their community research partnerships. This study examines ESIs’ experiences with a program that funded and supported their community-partnered pilot health disparities research.
Methods:
Fourteen ESIs from five cohorts of pilot investigators participated in in-depth focus groups between April 2020 and February 2024. Two reviewers independently identified significant quotes and created codes. Thematic analysis was used to develop relevant themes.
Results:
The overarching theme was that the program was a launch pad for the ESIs’ research careers. Four distinct sub-themes contributing to the launch pad theme were: (1) ESI Growth & Adaptation; (2) Community and Support; (3) The Value of Collaboration and Partnership; (4) Need for Effective Mentorship. The results suggest the program offered ESIs and community partners substantial, unique support and resources, but challenges remained.
Conclusions:
Future programs helping ESIs who conduct community-engaged research to launch their research careers should consider implementing tailored support while offering strategies to eliminate or reduce institutional barriers, including strengthening mentoring.
Catherine Parkin is a librarian at Leeds Beckett University (LBU), while Aarti Sehgal is a librarian at the University of Sheffield (TUoS). These institutions both have around 1200 students registered on a taught Law course. Against the background of an increased need to prove academic libraries are obtaining ‘value for money’ from subscription resources, alongside the desire for law students to be effective and critical users of information, this article explores database engagement activities carried out at the authors’ institutions. It considers the impact of teaching and online tutorials created to engage students with resources, and discusses tools used to check resource usage.
This research proposes an inexpensive technique for wireless image transfer for security and surveillance applications. The technique uses a 5.8 GHz transmitter and receiver module, along with external antennas in the real-time image transfer within a radius of 100 m. The transferred images are stored in a laptop using a Python code-based graphical user interface application. Different antennas, dipole, circular split-ring resonators, hexagonal split-ring resonators, and metamaterial antennas are utilized for comparison. The Blind/Referenceless Image Spatial Quality Evaluator method is used to assess the picture quality of transferred images to quantify image transfer performance when no ground truth or reference photos are supplied. According to the presented results, images transferred using metamaterial antennas have higher quality than those transferred with other types of antennas. For security considerations, such a system can communicate and store the images in real time.
We aimed to assess risk of COVID-19 infection & seroprotection status in healthcare workers (HCWs) in both hospital and community settings following an intensive vaccination drive in India.
Setting:
Tertiary Care Hospital
Methods:
We surveyed COVID-19 exposure risk, personal protective equipment (PPE) compliance, vaccination status, mental health & COVID-19 infection rate across different HCW cadres. Elecsys® test for COVID-19 spike (Anti-SARS-CoV-2S; ACOVs) and nucleocapsid (Anti-SARS-CoV-2; ACOV) responses following vaccination and/or COVID-19 infection were measured in a stratified sample of 386 HCW.
Results:
We enrolled 945 HCWs (60.6% male, age 35.9 ± 9.8 years, 352 nurses, 211 doctors, 248 paramedics & 134 support staff). Hospital PPE compliance was 90.8%. Vaccination coverage was 891/945 (94.3%). ACOVs neutralizing antibody was reactive in 381/386 (98.7%). ACOVs titer (U/ml) was higher in the post-COVID-19 infection group (N =269; 242.1 ± 35.7 U/ml) than in the post-vaccine or never infected subgroup (N = 115, 204.1 ± 81.3 U/ml). RT PCR + COVID-19 infections were documented in 224/945 (23.7%) and 6 HCWs had disease of moderate severity, with no deaths. However, 232/386 (60.1%) of HCWs tested positive for nucleocapsid ACOV antibody, suggesting undocumented or subclinical COVID-19 infection. On multivariate logistic regression, only female gender [aOR 1.79, 95% CI 1.07–3.0, P = .025] and COVID-19 family contact [aOR 5.1, 95% CI 3.84–9.5, P < .001] were predictors of risk of developing COVID-19 infection, independent of association with patient-related exposure.
Conclusion:
Our HCWs were PPE compliant and vaccine motivated, with immunization coverage of 94.3% and seroprotection rate of 98.7%. There was no relationship between HCW COVID-19 infection to exposure characteristics in the hospital. Vaccination reduced disease severity and prevented death in HCW.
Evaluate measures used to operationalize apathy in relation to cognitive impairment among Hispanic/Latin Americans and synthesize associations of apathy with cognitive impairment.
Participants and Methods:
A systematic review of the available literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. This review covered studies on the relationship between apathy and cognitive impairment among Hispanic/Latin Americans across normal aging and neurocognitive disorders. The first stage of the review consisted of collecting all publications that contained (1) English or Spanish-speaking participants, (2) with measures for reported apathy, (3) assessment of cognitive functioning or diagnosis of neurocognitive disorder, (4) with Hispanic/Latin Americans represented in the sample. There was no limit regarding publication date. The required minimum of H/L participants in selected studies was determined based on a standard of representation in the United States general population, which is around 18.5%. In the second stage of the review, studies were screened excluding all studies that did not meet the criteria.
Results:
Thirteen, 37, and 17 studies were identified by APA PsychInfo, EMBASE, and PubMed, respectively. After removing 19 duplicate records, 48 reports were then assessed for eligibility. Thirty-five of those reports were missing apathy and cognition associations, were under-reported in information such as conference abstracts, or were missing adequate representation of H/L participants. This resulted in a total of 13 papers included in this review. Of the eleven cross-sectional studies, nine demonstrated significant differences or associations between apathy and cognitive status, one demonstrated a descriptive difference between apathy and cognitive status (i.e., no hypothesis test conducted), while one demonstrated null effects. All effects suggested that as apathy increased, cognitive impairment increased. These cross-sectional studies spanned across Säo Paulo, Brazil, Los Angeles, California, West Texas, Cuba, the Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, and Southwestern United States. This included community and clinic samples of participants. Of the two longitudinal studies, they both demonstrated non-significant associations of apathy and cognitive status. One study in Mexico suggested a risk ratio over 1 where apathy was non-significantly associated with dementia risk, while the other study in Texas, United States had hazard ratios below 1 where apathy was non-significantly associated with mild cognitive impairment risk.
Conclusions:
The Neuropsychiatric Inventory (NPI) apathy subscale was the most used measure for apathy in this review (81.8% of included studies). However, a recent systematic review on apathy measurement in older adults and people with dementia specifically stated that the apathy dimension commonly used in the NPI should not be employed outside of screening for apathy. This suggests potential bias and poor evidence in the current literature consisting of apathy research with H/Ls. Longitudinal studies evaluating the utility of examining apathy in relation to cognitive impairment with diverse ethnoracial groups, in addition to Hispanic/Latin Americans, are warranted. Assessing construct equivalence of apathy across demographic characteristics such as language, education, and informant characteristics should be conducted to elucidate potential biases in measurement.
Integrating social and environmental determinants of health (SEDoH) into enterprise-wide clinical workflows and decision-making is one of the most important and challenging aspects of improving health equity. We engaged domain experts to develop a SEDoH informatics maturity model (SIMM) to help guide organizations to address technical, operational, and policy gaps.
Methods:
We established a core expert group consisting of developers, informaticists, and subject matter experts to identify different SIMM domains and define maturity levels. The candidate model (v0.9) was evaluated by 15 informaticists at a Center for Data to Health community meeting. After incorporating feedback, a second evaluation round for v1.0 collected feedback and self-assessments from 35 respondents from the National COVID Cohort Collaborative, the Center for Leading Innovation and Collaboration’s Informatics Enterprise Committee, and a publicly available online self-assessment tool.
Results:
We developed a SIMM comprising seven maturity levels across five domains: data collection policies, data collection methods and technologies, technology platforms for analysis and visualization, analytics capacity, and operational and strategic impact. The evaluation demonstrated relatively high maturity in analytics and technological capacity, but more moderate maturity in operational and strategic impact among academic medical centers. Changes made to the tool in between rounds improved its ability to discriminate between intermediate maturity levels.
Conclusion:
The SIMM can help organizations identify current gaps and next steps in improving SEDoH informatics. Improving the collection and use of SEDoH data is one important component of addressing health inequities.
We examined the influence of racial and ethnic identity of residents and housing market economic conditions on redlining. Data were extracted from archival area description forms from the Home Owners’ Loan Corporation for 568 Ohio neighborhoods from 1934–1940. Logistic regression analysis was used to analyze the relationships between neighborhood characteristics and redlining. Bivariate results indicated a strong association between the presence of African American residents and neighborhood redlining (OR = 40.9, 95% CI 22.9-72.8). Multivariable analysis demonstrated that some neighborhood characteristics were contributors to the decision to redline, including homes in poor condition (OR = 4.3, 95% CI 1.2-15.1), home vacancy (OR = 1.4, 95% CI 1.1-1.6), and housing prices (per thousand dollars) (OR = 0.7, 95% CI 0.4-1.2). Adjusting for these and other factors, the presence of African American residents remained a powerful predictor of redlining (OR = 13.8, 95% CI 4.4-42.8). Racial discrimination was the overriding factor in decisions to redline neighborhoods.
Compared to preterm appropriate for gestational age (AGA) fetuses, fetuses with fetal growth restriction (FGR) have earlier visualisation of coronary artery blood flow (CABF) but impaired cardiac function. This dichotomy remains uncharacterised during postnatal life. This study compared CABF and cardiac function in preterm FGR infants, against AGA infants during the postnatal period. FGR was defined as birthweight < 10th centile for gestation and sex with absent/reversed antenatal umbilical artery Doppler. Diastolic CABF was measured in the left anterior descending coronary artery. Twenty-eight FGR infants were compared with 26 AGA infants (gestation and birthweight, 29.7 ± 1.3 vs 29.9 ± 1 weeks, P = 0.6 and 918 ± 174 vs 1398 ± 263g, P < 0.001, respectively). Echocardiography was performed in the second week of life. FGR infants had higher CABF (velocity time integral, 2.4 ± 0.9 vs 1.6 ± 0.8 cm, P = 0.002). Diastolic function was impaired (↑ trans-mitral E/A ratio in FGR infants; 0.84 ± 0.05 vs 0.79 ± 0.03, P = 0.0002) while the systolic function was also affected (mean velocity of circumferential fibre shortening [mVCFc], 1.9 ± 0.3 vs 2.7 ± 0.5 circ/s, P < 0.001). Indexing CABF to cardiac function noted significant differences between the groups (CABF: E/A [FGR vs AGA], 2.9 ± 1.1 vs 2.1 ± 1, P = 0.01 and CABF: mVCFc [FGR vs AGA], 1.3 ± 0.5 vs 0.6 ± 0.3, P < 0.001). Diastolic blood pressure (BP) was significantly higher, and CABF to diastolic BP ratio trended higher in FGR infants (30 ± 2 vs 25 ± 3 mmHg, P < 0.001 and 0.08 ± 0.03 vs 0.06 ± 0.03, P = 0.059, respectively). Greater CABF in FGR infants did not translate into better cardiac function. This dichotomy may be a persistent response to fetal hypoxaemia (fetal programming) and/or reflection of altered cardiac architecture.
Bronchiolitis obliterans organising pneumonia is a rare complication associated with calcineurin inhibitors and mammalian target of rapamycin inhibitors. While bronchiolitis obliterans organising pneumonia in adult transplant patients has been reported, it has not been well described in pediatric transplant patients.
Case description:
We present a case of a 19-month-old male patient with dilated cardiomyopathy who underwent orthotropic heart transplantation at 14 months of life for heart failure refractory to medical therapy. Approximately 4 months post-transplant, he presented with diarrhea and vomiting with acute kidney injury secondary to dehydration. His tacrolimus level on admission and first week of hospitalisation was within target range of 10–12 ng/ml. He was diagnosed with esophagitis and prescribed proton pump inhibitors. Our patient subsequently developed significant respiratory distress with initial chest radiograph showing right lower lobe opacities. Repeat tacrolimus at the time of worsening respiratory status was 84.2 ng/dL and his tacrolimus was held. He required intubation due to significant hypoxia with progression of lung to disease and development of diffuse bilateral opacities consistent with acute respiratory distress syndrome. Despite initiation of steroids and aggressive ventilator management, he continued to be hypoxic on maximal respiratory support. After 28 days post admission, support was withdrawn. On autopsy, his lung biopsy findings were consistent with bronchiolitis obliterans organising pneumonia.
Conclusion:
Life-threatening bronchiolitis obliterans organising pneumonia can be seen in pediatric transplant patients on tacrolimus or when transitioning from tacrolimus to sirolimus, highlighting the need for close monitoring of heart transplant patients on immunosuppressive medications presenting with hypoxia.
The fossil record of treeshrews, hedgehogs, and other micromammals from the Lower Siwaliks of India is sparse. Here, we report on a new genus and species of fossil treeshrew, specimens of the hedgehog Galerix, and other micromammals from the middle Miocene (Lower Siwalik) deposits surrounding Ramnagar (Udhampur District, Jammu and Kashmir), at a fossil locality known as Dehari. The treeshrew from Dehari (Sivatupaia ramnagarensis n. gen. n. sp.) currently represents the oldest record of fossil tupaiids in the Siwaliks, extending their time range by ca. 2.5–4.0 Myr in the region. Dietary analyses suggest that the new tupaiid was likely adapted for a less mechanically challenging or more frugivorous diet compared to other extant and fossil tupaiids. The occurrence of Galerix has only been recently documented from the Indian Siwaliks and the Dehari specimens help establish the likely presence of a relatively large Siwalik Galerix species in the Ramnagar region. In addition to the new treeshrew and hedgehogs, new specimens of the rodents Kanisamys indicus, Sayimys sivalensis, and Murinae indet. from Dehari help confirm that age estimates for the Ramnagar region are equivalent to the Chinji Formation in Pakistan, most likely corresponding to the middle to upper part of the Chinji Formation.
India spans 3.3 million kilometres spread over 7,900 towns and around 600,000 villages. It has approximately 10 million retailers. The fast moving sector, which, along with automobile, consumer durables and pharmaceuticals, makes up the majority of the consumer industries (CI) sector, retails products from around 21,000 manufacturers producing a quarter of a million stock keeping units (SKUs) (Nielsen 2016). Add the other sectors, and the CI sector in India sells a million products to a billion Indians. Imagine doing that only with human intelligence.
The path to achieve stability for artificial intelligence (AI)-based implementation in the CI sector is nascent but the potential is becoming increasingly clear. The adoption of AI-based solutions in India has seen an upward trend in the past few years. Over the past few years, it has been observed that high-and mid-cap CI companies have benefitted from AI in their various practice lines. AI has delivered excellent results in terms of increased revenues, improved productivity and increased effectiveness of their promotional expenditures. Companies have seen tremendous changes in their transactional, distribution and marketing-based processes, thereby improving both top-line and bottom-line growth. The reason behind this key success is the ability of these organizations to combine AI-based technology with the human-in-the-loop to deliver efficient business outcomes at scale.
Having operated in the market for over two years, Digilytics AI, a category leader of easy-to-use SaaS AI products, finds that players in the consumer industry are extremely receptive to the use of AI and analytics to gain firstmover advantage. However, only a selected few companies understand the real benefits of AI and how to apply it. Despite a huge growth in the technology infrastructure in these companies, most continue to struggle with basic data quality issues. However, there is a consensus among business heads that there lies a huge potential in using AI and in all the major business functions within the company. With this positivity in the business sphere, companies have initiated the roll out of AI-based capabilities with the right steps in mind.
The Miocene beds of Kutch in India are well known for their mammalian assemblages, including the extinct ape Sivapithecus, but far less is known about the fossil squamates from this area. Although India with its over 800 reptile species is recognized as one of the global biodiversity hotspots, knowledge of past diversity and paleobiogeography of squamates on this subcontinent is very limited. We here report on new lizard finds, which have been recovered from two stratigraphic levels: the older Palasava locality (dated to the middle Miocene, ca. 14 Ma) and the younger Tapar site (late Miocene, ca. 11–10 Ma). Although fragmentarily preserved, the material described here sheds important light on the composition and paleobiogeography of squamates during the Miocene in South Asia. The older Palasava locality contains cf. Uromastyx s.l. and Varanus sp., the latter representing the oldest record of this taxon in the region of India south of the Himalayas and its occurrence here suggests a mean annual temperature not less than 15°C. The material from the younger Tapar locality consists of an unidentified acrodontan lizard, here questionably placed in agamids, and a skink. The latter shows a resemblance to mabuyines, however, the fragmentary nature of the material does not allow a precise allocation without doubts. The cosmopolitan mabuyines have been suggested to have their origin in Asia, so the potential presence of mabuyines in the Tapar locality might represent the first, but putative, Asian evidence of the occurrence of this group in the Miocene.
Coronavirus disease 2019 (COVID-19) emerged from a city in China and has now spread as a global pandemic affecting millions of individuals. The causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is being extensively studied in terms of its genetic epidemiology using genomic approaches. Andhra Pradesh is one of the major states of India with the third-largest number of COVID-19 cases with a limited understanding of its genetic epidemiology. In this study, we have sequenced 293 SARS-CoV-2 genome isolates from Andhra Pradesh with a mean coverage of 13324X. We identified 564 high-quality SARS-CoV-2 variants. A total of 18 variants mapped to reverse transcription polymerase chain reaction primer/probe sites, and four variants are known to be associated with an increase in infectivity. Phylogenetic analysis of the genomes revealed the circulating SARS-CoV-2 in Andhra Pradesh majorly clustered under the clade A2a (20A, 20B and 20C) (94%), whereas 6% fall under the I/A3i clade, a clade previously defined to be present in large numbers in India. To the best of our knowledge, this is the most comprehensive genetic epidemiological analysis performed for the state of Andhra Pradesh.
Down syndrome is a well-recognised genetic condition associated with several comorbidities. Although CHD is common in Down syndrome, transposition of the great arteries is exceptionally rare. We describe a neonate with Down syndrome who presented with transient abnormal myelopoiesis and transposition of the great arteries. Down syndrome may accelerate pulmonary hypertension in transposition of the great arteries and is associated with poor outcomes.
OBJECTIVES/GOALS: The detection of liver fibrotic changes at an early and reversible stage is essential to prevent its progression to end-stage cirrhosis and hepatocellular carcinoma. Liver biopsy, which is the current gold standard for fibrosis assessment, is accompanied by several complications due to its invasive nature in addition to sampling errors and reader variability. In this study, we evaluate the use of quantitative parameters extracted from hybrid ultrasound and photoacoustic imaging to detect and monitor fibrotic changes in a DEN rat model. METHODS/STUDY POPULATION: Liver fibrotic changes were induced in 34 Wistar male rats by oral administration of Diethylnitrosamine (DEN) for 12 weeks. 22 rats were imaged with B-mode ultrasound at 3 different time points (baseline, 10 weeks and 13 weeks) for monitoring liver texture changes. Texture features studied included tissue echointensity (liver brightness normalized to kidney brightness) and tissue heterogeneity. 12 rats were imaged with photoacoustic imaging at 4 time points (baseline, 5 wks, 10 wks, and 13 wks) to look at changes in tissue oxygenation. Hemoglobin oxygen saturation (sO2A) and hemoglobin concentration (HbT) in the right and left lobes of the liver were measured. 8 rats were used as controls. Liver tissue samples were obtained following 13 weeks from DEN start time for METAVIR histopathology staging of fibrosis. RESULTS/ANTICIPATED RESULTS: Texture features studied showed an increase with time in DEN rats. Normalized echointensity increased from 0.28 ± 0.06 at baseline to 0.46 ± 0.10 at 10 weeks (p < 0.0005) and 0.53 ± 0.15 at 13 weeks in DEN rats (p < 0.0005). In the control rats, echointensity remained at an average of 0.25 ± 0.05 (p = 0.31). Tissue heterogeneity increased over time in the DEN-exposed rats from a baseline of 208.7 ± 58.3 to 344.6 ± 52.9 at 10 weeks (p < 0.0005) and 376.8 ± 54.9 at 13 weeks (p = 0.06) however it stayed constant at 225.7 ± 37.6 in control rats (p = 0.58). The quantitative analyses of the photoacoustic signals showed that blood oxygen saturation significantly increased with time. At 5 weeks sO2AvT increased by 53.83 % (± 0.25), and HbT by 35.31 % (± 0.07). Following 10 weeks of DEN; sO2AvT by 92.04 % (± 0.29), and HbT by 55.24 % (± 0.1). All increases were significant p < 0.05. In the 13th week, however, the values of all of these parameters were lower than those in the 10th week, however, the decrease was statistically insignificant. DISCUSSION/SIGNIFICANCE OF IMPACT: Quantitative features from B-mode ultrasound and photoacoustic imaging consistently increased over time corresponding to hepatic damage, inflammation and fibrosis progressed. The use of this hybrid imaging method in clinical practice can help meet the significant need for noninvasive assessment of liver fibrosis.
This chapter serves as a guide to gastrointestinal (GI) endoscopy for the histopathologist for benign pathology and outlines the value to endoscopists of GI biopsies. It sets out to explain to a histopathology audience the decision-making process that endoscopists undertake when performing an endoscopic procedure and, crucially, what they need in return in a pathology report. There are explanations as to the thought processes that lead to endoscopic biopsies both in macroscopic disease and, perhaps more importantly, when appearances are normal. There is a guide to each anatomical area detailing how, where, and when to take samples from each region from the oesophagus to the rectum, followed by detailed up-to-date explanations on the latest guidelines for endoscopic sampling for each disease state. For each anatomical area there are practice point summaries and for some diseases detailed endoscopic pictures. The goal of this chapter is to enhance the pathologist’s knowledge of endoscopy, benign GI disease, and national and international sampling guidelines. Finally, we hope it serves as a guide for enhanced discussion between endoscopists and pathologists and encourages a collaborative approach to disease diagnosis.
Pompe disease is a type-II glycogen storage disease, and clinical manifestations include hypertrophic cardiomyopathy and generalised muscular hypotonia. Enzyme replacement therapy has proven to be effective in reversing the ventricular hypertrophy. The outcomes are variable depending on time to diagnosis and severity of the cardiac disease. We describe two contrasting cases of patients with infantile-onset Pompe disease. The first child was diagnosed late and had severe cardiac hypertrophy with respiratory decompensation and ventilator dependence and eventual death. The second case was diagnosed at birth with early initiation of therapy resulting in a good outcome. Our cases highlight the importance of early initiation of enzyme replacement therapy to improve clinical outcomes.
By providing the first comprehensive account of the role of the British and Indian press in war propaganda, this article makes an intervention in the global history of the First World War. The positive propaganda early in the war, intertwined with a rhetoric of loyalism, contrasted with how the conservative British press affixed blame for military defeats in Mesopotamia upon the colonial regime's failure to effectively mobilize India's resources. Using a highly emotive and enduring trope of the ‘Mesopotamia muddle’, the Northcliffe press was successful in channelling a high degree of public scrutiny onto the campaign. The effectiveness of this criticism ensured that debates about the Mesopotamian debacle became a vehicle for registering criticism of structures of colonial rule and control in India. On the one hand, this critique hastened constitutional reforms and devolution in colonial India and, on the other, it led to demands that the inadequacy of India's contribution to the war be remedied by raising war loans. Both the colonial government and its nationalist critics were briefly and paradoxically united in opposing these demands. The coercive extraction of funds for the imperial war effort as well as the British press's vituperative criticism contributed to a post-war, anti-colonial political upsurge. The procedure of creating a colonial ‘scandal’ out of a military disaster required a specific politics for assessing the regulated flows of information, which proved to be highly effective in shaping both the enquiry that followed and the politics of interwar colonial South Asia.