Smart water management framework for irrigation in agriculture

Global demand and pressure on natural resources is increasing, which is greater on the availability of pure and safe drinking water. The use of new-age technologies including Smart sensors, embedded devices, and Cloud computing can help deliver efficient and safe management for provisioning drinking water for consumers and irrigation for agriculture. The management actions combined with real-time data gathering, monitoring, and alerting with proactive actions, prevent issues from occurring. This research presents a secure and smart research framework to enhance the existing irrigation system. This involves a low-budget irrigation model that can provide automated control and requirements as per the season, climate by using smart device sensors and Cloud communications. The authors presented four unique algorithms and water management processing rules. This also includes alerting scenarios for device and component failures and water leakage by automatically switching to alternative mode and sending alert messages about the faults to resolve the operational failures.The objective of this research is to identify new-age technologies for providing efficient and effective farming methods and investigate Smart IoT-based water management. The highlights of this research are to investigate IoT water management systems using algorithms for irrigation farming, for which this research presents a secure and smart research framework. This involves a low-budget irrigation model that provides automated control and requirements as per the season, climate by using smart device sensors and Cloud communications. Alerts for device and component failures and water leakage are also in-built for switching to alternative mode to resolve the operational failures.

Decoupling of ion-transport from polymer segmental relaxation and higher ionic-conductivity in poly(ethylene oxide)/succinonitrile composite-based electrolytes having low lithium salt doping

Only limited enhancement in room-temperature ionic-conductivity for poly(ethylene oxide), PEO, based electrolytes is possible due to coupling between ionic-conductivity and segmental relaxation. In the present study, we have achieved ionic-conductivity of 1.07 × 10-3 and 6.20 × 10-4 S cm-1 at 313 and 298 K, respectively, by adding 45 wt% of succinonitrile (SN) in PEO having low LiTFSI loading (Li : EO = 1 : 20). This enhancement in the ionic-conductivity is attributed to faster ion transport (diffusion coefficient, D = 3.63 × 10-5 cm2 s-1) occurring through the ion-transport channels as confirmed by positron annihilation lifetime spectroscopy. The ionic-transport through these channels is observed to be highly decoupled from the segmental relaxations as confirmed using broadband dielectric spectroscopy through Ratner's approach. The observed decoupling of ionic-conductivity from PEO segmental relaxation in PEO-SN composite-based electrolytes would be useful to design rather inexpensive all solid-state polymer electrolytes for Li ion batteries.

Supervise the physicochemical quality of ground water using soft computing technique

Water resources are essential for human beings and nowadays polluted water jeopardizes the human health. Toxic substances come from houses, industries and farm lands, dust mix with water causes water pollution. This pollution depreciates the quality of water and affects the human life. In this paper, our objective is to evaluate and supervise the physicochemical quality of the ground water, for the safety of human beings. The sample quality of 15 sites was used for measuring important parameters like pH, EC, Ca2+, Mg2+, Na+, K+, Cl-, SO42-, Also, NH4+ and NO3-, Fe2+ and HCO3-12 were considered for performance analysis. A soft computing component fuzzy logic system is used to design an intelligent system. The fuzzy logic system-based model measures groundwater quality status along with its sustainability. The results obtained from the model help the authorities, policy makers to plan proper policies for geochemical operation (water treatment process) and a foundation for observing the physicochemical quality of water in the area.

Comprehensive characterization of the structure of Zr-based metallic glasses

Structure of metallic glasses fascinates as the generic amorphous structural template for ubiquitous systems. Its specification necessitates determination of the complete hierarchical structure, starting from short-range-order (SRO) → medium-range-order (MRO) → bulk structure and free volume (FV) distribution. This link has largely remained elusive since previous investigations adopted one-technique-at-a-time approach, focusing on limited aspects of any one domain. Reconstruction of structure from experimental data inversion is non-unique for many of these techniques. As a result, complete and precise structural understanding of glass has not emerged yet. In this work, we demonstrate the first experimental pathway for reconstruction of the integrated structure, forZr 67 Ni 33 andZr 52 Ti 6 Al 10 Cu 18 Ni 14 glasses. Our strategy engages diverse (× 7) multi-scale techniques [XAFS, 3D-APT, ABED/NBED, FEM, XRD, PAS, FHREM] on the same glass. This strategy complemented mutual limitations of techniques and corroborated common parameters to generate complete, self-consistent and precise parameters. Further, MRO domain size and inter-void separation were correlated to identify the presence of FV at MRO boundaries. This enabled the first experimental reconstruction of hierarchical subset: SRO → MRO → FV → bulk structure. The first ever image of intermediate region between MRO domains emerged from this link. We clarify that determination of all subsets is not our objective; the essence and novelty of this work lies in directing the pathway towards finite solution, in the most logical and unambiguous way.

Trace elements dyshomeostasis in liver and brain of weanling mice under altered dietary selenium conditions

BACKGROUND

A balanced diet containing selenium (Se) and other trace elements is essential for normal development and growth. Se has been recognized as an essential trace element; however, its interaction with other elements has not been fully investigated. In the present study, sodium (Na), magnesium (Mg), potassium (K), calcium (Ca), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), copper (Cu), zinc (Zn), Se and rubidium (Rb), were analysed in liver and brain regions under altered dietary Se intake in weanling mice to identify major discriminatory elements.

METHODS

The study investigated the effects of different levels of Se intake on the elemental composition in liver and brain tissues of weaned mice. After 24 weeks of feeding with Se adequate, deficient, and excess diets, elemental analysis was performed on the harvested tissues using Inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis that included analysis of covariance (ANCOVA), correlation coefficient analysis, principal component analysis, and partial least squares discriminant analysis were performed.

RESULTS

The ANCOVA showed statistically significant changes and correlations among the analysed elements under altered dietary Se status. The multivariate analysis showed differential changes in elements in liver and brain regions. The results suggest that long-term dietary Se alternations lead to dyshomeostasis in trace elements that are required in higher concentrations compared to Se. It was observed that changes in the Fe, Co, and Rb levels were similar in all the tissues studied, whereas the changes in Mg, Cr, and Mn levels were different among the tissues under altered dietary Se status. Additionally, the changes in Rb levels correlated with the dietary Se intake but had no relation with the tissue Se levels.

CONCLUSIONS

The findings suggest interactions between Mg, Cr, Mn, Fe, Co, and Se under altered Se status may impact cellular functions during postnatal development. However, the possible biological significance of alterations in Rb levels under different dietary Se paradigms needs to be further explored.

Studies on the breeding potential and entomological indices of dengue vector Aedes aegypti and Aedes albopictus in the district Ghaziabad of Uttar Pradesh, India

BACKGROUND & OBJECTIVES

The female Aedes mosquito is a vector of many arboviruses-borne diseases. The evidence and information regarding their breeding habitats are vital for implementing appropriate control policies.

METHODS

An entomological survey was done at three sites in Ghaziabad district of Uttar Pradesh, India viz. Indirapuram, Vasundhara, and Vaishali to generate the first boundary line information of breeding sites of Aedes aegypti larvae for the early prevention and control interventions for dengue management.

RESULTS

A total of 2994 containers were checked in 1169 households at the time of the survey for breeding sites of Aedes mosquito during the pre-monsoon, monsoon, and post-monsoon period, out of which 667 containers were found positive in 518 positive households. The total HI, CI, and BI were 44.31, 22.27, and 57.05 respectively. The maximum and minimum breeding indices were found during monsoon and pre-monsoon respectively. The most preferred containers for Aedes breeding were cement tanks for lotus plants in nurseries, drums, and small and large size pots for storage of water and ornamental plants mostly in 8 plant nurseries.

INTERPRETATION & CONCLUSION

Breeding of Aedes was found in nurseries and desert coolers which were the primary breeding containers found during the survey. The containers found positive during surveys were emptied or destroyed with the help of the local community and the breeding status of nurseries was informed to the health authorities of Ghaziabad to take necessary action against the breeding sites of the Aedes mosquitoes.

Elemental Composition and Sources of Fine Particulate Matter (PM2.5) in Delhi, India

In this study we have analysed the elemental composition of fine particulate matter (PM_2.5) to examine the seasonal changes and sources of the elements in Delhi, India from January, 2017 to December, 2021. During the entire sampling period, 19 elements (Al, Fe, Ti, Cu, Zn, Cr, Ni, As, Mo, Cl, P, S, K, Pb, Na, Mg, Ca, Mn, and Br) of PM_2.5 were identified by Wavelength Dispersive X-ray Fluorescence Spectrometer. The higher annual mean concentrations of S (2.29 µg m^-3), Cl (2.26 µg m^-3), K (2.05 µg m^-3), Ca (0.96 µg m^-3) and Fe (0.93 µg m^-3) were recorded during post-monsoon season followed by Zn > Pb > Al > Na > Cu > Ti > As > Cr > Mo > Br > Mg > Ni > Mn > and P. The annual mean concentrations of elemental composition of PM_2.5 accounted for 10% of PM_2.5 (pooled estimate of 5 year). Principal Component Analysis (PCA) identified the five main sources [crustal/soil/road dust, combustion (BB + FFC), vehicular emissions (VE), industrial emissions (IE) and mixed source (Ti, Cr and Mo rich-source)] of PM_2.5 in Delhi, India.

On enhancing the Li-ion conductivity of quasi-solid-state electrolytes by suppressing the flexibility of zeolitic imidazolate framework-8 via a mixed ligand strategy

Zeolitic imidazole frameworks (ZIFs) have emerged as potential conductive materials for Li ion-transport in polymer solid state electrolytes. However, developing ZIFs with high Li ionic conductivity is rather limited due to their flexible frameworks allowing dual ion conduction. Herein, we have used a mixed ligand strategy for fine-tuning the aperture and enhancing the rigidity of ZIF-8, which restricts the passage of large size anions. Poly(ethylene oxide)-based quasi-solid state electrolytes utilizing mixed ligand ZIF-7-8 frameworks as passive fillers show a continuous enhancement in Li ion-conductivity exclusively attributed to modifications in the flexibility and pore architecture of ZIF-8 as confirmed through broadband dielectric spectroscopy and positron annihilation spectroscopy. This study shows that polymer segmental relaxation and conductivity relaxation processes are decoupled in these electrolytes. Consequently, our proposed approach provides a new strategy for manufacturing a polymer-based electrolyte with enhanced ionic conductivity.

Modular electromagnetic railgun accelerator for high velocity impact studies

A modular electromagnetic railgun accelerator facility named "RAFTAR" (i.e., Railgun Accelerator Facility for Technology and Research) has been commissioned and its performance has been characterized for high velocity impact testing on materials in a single-shot mode. In the first tests, RAFTAR demonstrated an acceleration of more than 1000 m/s for an 8 g solid aluminum-7075 armature projectile. The current fed was 220 kA, having a muzzle time of about 1.75 ms. It is a single pulse breech-fed rectangular bore (14 × 13 mm²) railgun, and its 1.15 m long barrel assembly consists of two parallel copper bars with an inter-gap of 13 mm that are encased within 50 mm thick high strength reinforced fiberglass sheets (Garolite G10-FR4) and bolted from both the sides. RAFTAR is powered by two capacitor bank modules that have a maximum stored energy of 160 kJ each (containing eight 178 μF/15 kV capacitors), two high power ignitron switches, and a pulse shaping inductor. To obtain consistent acceleration of the armature inside the barrel, reversal of driving current is prevented, and its pulse duration is stretched by tactical integration of the crowbar switch and bitter coil inductor in the circuit. Armature projectile velocity measurement in-bore and outside in free space was performed by the time-of-flight technique using indigenously made miniature B-dot sensors and a novel shorting-foil arrangement, respectively. The time resolved measurement of the in-bore armature evidenced a velocity-skin-effect in the high acceleration phase. There is good agreement between the experimentally measured and theoretically predicted efficiency, confirming the optimal choice of operating parameters. The conclusion summarizes important experimental findings and analyzes the underlying causes that limit the performance of railguns.

Factors associated with health-related quality of life in heart failure in 23,000 patients from 40 countries: results of the global congestive heart failure research program

Background

Poor health-related quality of life (HRQL) is common in heart failure (HF) and strongly predicts death and HF hospitalization in all regions of the world. Understanding facors associated with HRQL could therefore lead to improved prognosis in HF patients. Despite that the majority of HF occurs in low- and middle-income countries, there are limited data characterizing self-perceived health HRQL and its correlates in these settings.

Purpose

To examine clinical and social correlates of HRQL in patients with HF from high- (HIC), upper middle- (UMIC), lower middle-(LMIC) and low-income (LIC) countries.

Methods

Between 2017 and 2020, we enrolled 23,292 patients with HF (32% inpatients, 61% men) from 40 countries in the Global Congestive Heart Failure Study. We recorded HRQL at baseline using Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0–100, higher=better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimates expressed as β-coefficients) of KCCQ-12-SS with sociodemographic-, comorbidity-, treatment- and symptom-covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. We used partial R2-estimates to understand the contribution to the variability in KCCQ-12-SS of 4 different groups of covariates. (sociodemographic, comorbidities, treatments and signs and symptoms of congestion).

Results

Mean age was 63 years and 40% were in NYHA class III–IV. Average HRQL was 55± SD 0.5. It was 62.5 (95% CI 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p<0.0001). Strong correlates (β-coefficient [95% CI]) of KCCQ-12-SS were NYHA class III vs class I/II (−12.1 [−12.8 to −11.4] and class IV vs. class I/II (−16.5 [−17.7 to −15.3]), effort dyspnea (−9.5 [−10.2 to −8.8]) and living in LIC vs. HIC (−5.8 [−7.1 to −4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R2=0.32 of total adjusted R2=0.51), followed by sociodemographic factors (R2=0.12). Results were consistent in populations across income levels.

Conclusion

The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country-income level. Improved symptom control may have a big impact on HRQL, especially in LICs.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer AG

Development of an app-based bedside clinical decision-making tool for mechanical cardiocirculatory support in patients with cardiogenic shock: the MCS-Aid app

Background

Patients presenting with cardiogenic shock remain at high risk of morbidity and mortality. Several mechanical cardiocirculatory support (MCS) devices have been developed and their use is rapidly increase in clinical practice. However, there is significant heterogeneity in patient selection, timing of implantation, and post-implantation management across centers and operators.

Purpose

We sought to develop and smartphone app-based clinical decision-making tool to help bedside selection and post-implantation management of MCS devices in patients presenting with cardiogenic shock or cardiac arrest.

Methods

The MCS-Aid app will consistent of 3 major sections: (i) initial device selection based on clinical presentation (patients with cardiogenic shock or cardiac arrest post-ROSC); (ii) guide for escalation or addition of MCS based on the individual hemodynamic scenario; (iii) guide for weaning after implantation of MCS device. The app will have an interactive interface that will allow the user to select the most appropriate next step in management based on the clinical information being entered. A calculator to derive key hemodynamic parameters (e.g. cardiac power output or pulmonary artery pulsatility index) will be incorporated in the App to inform clinical decision-making when appropriate. An example of an algorithm that will be part of the MCS-Aid app is illustrated in the figure.

Conclusions

The MCS-Aid app is an user-friendly bedside clinical decision tool that could help fellows-in-training, early-career interventionalist and interventional cardiologist to select the appropriate MCS device according to the individual clinical and hemodynamic scenario.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Abiomed

Effect of aspirin discontinuation according to individualised patient bleeding and ischemic risks after PCI: a TWILIGHT trial sub-analysis

Background

The TWILIGHT trial demonstrated a reduction in BARC 2, 3 or 5 (BARC-235) bleeding without an increase in ischemic events at 1-year in high-risk PCI patients randomized to placebo or aspirin (ASA) on a background of ticagrelor 3-months after PCI. However, the effect of ASA discontinuation according to baseline risk of bleeding and ischemic events remain unclear.

Purpose

To a) develop separate models to predict the risk of bleeding and ischemic events, and b) to assess treatment effect of ASA discontinuation across the risk strata.

Methods

Using the TWILIGHT patient database (N=7,119), two multivariable models, one for BARC-235 bleeding and one for CV death, nonfatal MI or nonfatal ischemic stroke (ischemic endpoint) were developed, and their predictive capacity was assessed. The effect of randomized treatment on bleeding and ischemic events across different patient risk-group categories as determined by the risk scores was investigated.

Results

At 1-year, 350 (5.4%) patients experienced a BARC-235 bleeding event and 258 (3.6%) experienced an ischemic event. Independent predictors of BARC-235 included haemoglobin levels at index PCI, proton-pump inhibitor non-use at discharge, age, liver disease and active smoking (c-statistic 0.64). Independent predictors of the ischemic outcome included a positive troponin ACS, prior CABG, diabetes, age, peripheral artery disease, prior PCI, a history of congestive heart failure, active smoking, the level of index PCI complexity, and prior MI (c-statistic 0.71). The risk of a BARC-235 almost doubled between patients in lower versus higher bleeding risk categories (4.3% versus 7.9%) and ischemic risk more than tripled between patients in lower versus higher ischemic risk categories (2.0% versus 7.0%) (see Figure 1). There was no evidence of a differential treatment effect for dual antiplatelet therapy versus ticagrelor monotherapy across the different risk categories of bleeding (interaction P=0.54) and ischemic risk (interaction P=0.95) (Table 1).

Conclusion

Individual patient bleeding and ischemic risks after PCI can both be readily characterised with good discrimination. The effect of ASA discontinuation in preventing bleeding in ticagrelor-treated patients was consistent regardless of baseline bleeding risk. There was no evidence for increased ischemic events with ASA discontinuation according to baseline ischemic risk.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZenecaIcahn School of Medicine at Mount Sinai

The conundrum of olecranon aperture and its relation to the distal end of the humerus in a modern Indian population: An anatomical and surgical perspective

PURPOSE

We aimed to clarify the morphology of the olecranon aperture (OA) of the humerus with its relationship to the distal end of the humerus (epicondylar width) and the width of the medullary canal.

METHODS

In total, 156 dry adult humeri were examined for the presence of OA. When present, we reported their shape, measured transverse (TD) and vertical diameter (VD), the distance from its medial border to the tip of medial epicondyle (D1), lateral border to the tip of lateral epicondyle (D2) and lower border to the tip of trochlea (D3). The epicondylar width (EW) and the width of the medullary canal were also measured in all the humeri.

RESULTS

OA was reported in 32 humeri (20.6%) with left side predominance, translucent septum in 35.8%, and opaque septum in 43.6%. The most typical shape noted was oval. On right side, mean VD and TD was 4.30±0.54mm and 5.85±0.45mm, respectively, whereas on left, these value were 4.21±0.56mm and 5.64±0.43mm, respectively. The mean of D1, D2 and D3 was 25.86±0.43mm, 26.50±0.28mm and 15.07±0.53mm on right and 24.80±0.41mm, 26.84±0.21mm and 15.81±0.31mm on left with significant difference (P<0.05). The medullary canal was significantly smaller in humeri with OA.

CONCLUSION

Topographic location of OA may have possible role in determining safe zone for retrograde nailing in supracondylar humeral fractures. Since OA has a direct relation to the size of the intramedullary canal, it is crucial during preoperative planning and choosing an adequate surgical approach involving lower segment of humerus.

Long-Term Variation in Carbonaceous Components of PM2.5 from 2012 to 2021 in Delhi

Carbonaceous species [organic carbon (OC), elemental carbon (EC), elemental matter (EM), primary organic carbon (POC), secondary organic carbon (SOC), total carbon (TC), and total carbonaceous matter (TCM)] of PM_2.5 were analyzed to study the seasonal variability and long-term trend of carbonaceous aerosols (CAs) in megacity Delhi, India from January, 2012 to April, 2021. The average concentrations (± standard deviation) of PM_2.5, OC, EC, TC, EM, TCM, POC and SOC were 127 ± 77, 15.7 ± 11.6, 7.4 ± 5.1, 23.1 ± 16.5, 8.2 ± 5.6, 33.3 ± 23.9, 9.3 ± 6.3 and 6.5 ± 5.3 µg m^-3, respectively during the sampling period (10-year average). The average CAs accounted for 26% of PM_2.5 concentration during the entire sampling period. In addition, the seasonal variations in PM_2.5, OC, EC, POC, SOC, and TCM levels were recorded with maxima in post-monsoon and minima in monsoon seasons. The linear relationship of OC and EC, OC/EC and EC/TC ratios suggested that the vehicular emissions (VE), fossil fuel combustion (FFC) and biomass burning (BB) are the major sources of CAs at megacity Delhi, India.

Aqueously altered igneous rocks sampled on the floor of Jezero crater, Mars

The Perseverance rover landed in Jezero crater, Mars, to investigate ancient lake and river deposits. We report observations of the crater floor, below the crater's sedimentary delta, finding the floor consists of igneous rocks altered by water. The lowest exposed unit, informally named Séítah, is a coarsely crystalline olivine-rich rock, which accumulated at the base of a magma body. Fe-Mg carbonates along grain boundaries indicate reactions with CO₂-rich water, under water-poor conditions. Overlying Séítah is a unit informally named Máaz, which we interpret as lava flows or the chemical complement to Séítah in a layered igneous body. Voids in these rocks contain sulfates and perchlorates, likely introduced by later near-surface brine evaporation. Core samples of these rocks were stored aboard Perseverance for potential return to Earth.

Effect of nurse-led lifestyle modification follow up program on health outcomes and quality of life among post myocardial infarction patients: a randomized controlled trial

Funding Acknowledgements

Type of funding sources: None.

Background

India has among the world's highest burden of cardiovascular disease, potentially contributed by myocardial infarction. Despite growing trouble, there are no known post-discharge programs & randomized trials reporting health status outcomes & quality of life among post-myocardial infarction patients. Cardiac rehabilitation programs reduce mortality, therefore, it is crucial to understand the local burden of the disease, common challenges, public perceptions, develop timely & effective interventional programs.

Purpose

This study aimed to evaluate the effect of a nurse-led lifestyle modification follow-up program on health outcomes & quality of life among post-myocardial infarction patients.

Methods

A two-arm randomized controlled trial was adopted & 104 post-myocardial infarction patients were recruited from August to December 2021. An equal number of participants were randomly assigned to intervention & control group by random number table generator. The control group patients received routine care, while the intervention group was provided routine care along with a nurse-led lifestyle modification follow-up program(health education, educational booklet, & telephone follow- up). A low-cost intervention based on information-motivation-behavioural skill model was developed. It was designed according to the needs of patients to know their risk factors, help patients establish a knowledge base, & adapt to the post-illness lifestyle changes. Data were assessed & compared by using the demographic datasheet, health outcomes datasheet, & MacNew heart disease quality of life questionnaire. All evaluations were conducted at baseline after 12 weeks post-discharge, by face-to-face interview & biophysiological measurements.

Results

The nurse-led lifestyle modification follow-up program was convenient for clinical application. The intervention group showed a appreciable improvement in low density lipoprotein(p=0.045), systolic blood pressure(p=0.009), diastolic blood pressure(p=0.044), body mass index(p=0.043), and NT ProBNP(p=0.007). The program effectively improved the lifestyle behaviours thereby considerably improving the quality of life in all the subscales-physical, emotional & social (p&lt;0.001) after 12 weeks of discharge.

Conclusion

In the Indian context, it is a novel & extensive approach to improve access to health care and emphasizes post-discharge self-management. The greatest benefit of this program was allowing the intervention group participants to consult with us immediately. Since lifestyles vary among different individuals, we considered individuality when providing education & involving them in implementation of an intervention to enhance their confidence & ultimately achieve optimal health outcomes & quality of life. The findings of this study are important for health care professionals caring for post-myocardial infarction patients & direct incorporation of such programs into routine practice to reduce morbidity & mortality.

Undiagnosed and Uncontrolled Hypertension and Access to Health Care among Residents of an Urban Area of Eastern Nepal: a Cross-sectional Study

Background The burden and complication of hypertension is increasing as most of the people living with hypertension are unaware of their condition and those who are already diagnosed with it do not have their blood pressure under control. Objective To assess the prevalence of undiagnosed and uncontrolled hypertension among residents of Itahari sub metropolitan city of eastern Nepal, along with its associated socio demographic and behavioral risk factors and access to health care services. Method Cross sectional study was conducted in five wards of Itahari, among 1161 participants, using population proportionate to sample size sampling technique. Face to face interview was conducted with participants for data collection applying semi- structured questionnaire and physical measurement like blood pressure, weight and height. Result Prevalence of hypertension was 26.5% includingundiagnosed 11.0% and previously diagnosed 15.5%. Among diagnosed, 76.6% had uncontrolled blood pressure and 56.70% were taking anti-hypertensive medicine, and 7.8% were under Ayurvedic medicine. More than 70% participants preferred private health facility for treatment and 22.7% had faced financial barrier to seek healthcare. About 64% of participants did not visit health services or had visited only once in past six months. Increasing age, Body Mass Index (BMI), smoking status and positive family history were found to be significantly associated with hypertension at < 0.05 level. Conclusion Prevalence of hypertension is high and awareness regarding available health services in local primary health center and its utilization is lacking among participants. Regular screening program for hypertension and awareness program to disseminate the knowledge of availability of primary health center should be conducted.

A National Equity Initiative to Address Noncommunicable Diseases and Injuries: Findings and Recommendation from the Nepal NCDI Poverty Commission

We aimed to assess the burden of NCDIs across socioeconomic groups, their economic impact, existing health service readiness and availability, current policy frameworks and national investment, and planned programmatic initiatives in Nepal through a comprehensive literature review. Secondary data from Global Burden of Disease estimates from GBD 2015 and National Living Standard Survey 2011 were used to estimate the burden of NCDI and present the relationship of NCDI burden with socioeconomic status. The Commission used these data to define priority NCDI conditions and recommend potential cost-effective, poverty-averting, and equity-promoting health system interventions. NCDIs disproportionately affect the health and well-being of poorer populations in Nepal and cause significant impoverishment. The Commission found a high diversity of NCDIs in Nepal, with approximately 60% of the morbidity and mortality caused by NCDIs without primary quantified behavioral or metabolic risk factors, and nearly half of all NCDI-related DALYs occurring in Nepalese younger than 40 years. The Commission prioritized an expanded set of twenty-five NCDI conditions and recommended introduction or scale-up of twenty-three evidence-based health sector interventions. Implementation of these interventions would avert an estimated 9680 premature deaths per annum by 2030 and would cost approximately $8.76 per capita. The Commission modelled potential financing mechanisms, including increased excise taxation on tobacco, alcohol, and sugar-sweetened beverages, which would provide significant revenue for NCDI-related expenditures. Overall, the Commission's conclusions are expected to be a valuable contribution to equitable NCDI planning in Nepal and similar resource-constrained settings globally.

A study to explore the appropriateness of dosing regimen of vancomycin in critically ill patients in a tertiary care unit of India

Introduction

Vancomycin is used in proven or suspected MRSA and MRE infections. An AUC/MIC ratio of ≥400 is the current accepted critical PK/PD"efficacy" target of vancomycin activity. The present study was conducted to ascertain the appropriateness of practice of current dosage regimen of vancomycin (1 g BD) based on population pharmacokinetic approach.

Methods

A single-center prospective study with the ICU setting of a tertiary care center was conducted. A total of 15 adult patients with sepsis treated with vancomycin were included over 15 months from May 2019 to July 2020. Blood samples were obtained at 5, 10, and 30 minutes and thereafter at 2 and 6 hours following the completion of the vancomycin infusion. The data obtained from HPLC estimation was analyzed using a population pharmacokinetic approach with NLME, Phoenix 8.3.2.166. The pharmacokinetic model was based on covariates such as bodyweight and urinary creatinine clearance to predict drug concentrations.

Results

A total of 83 vancomycin blood samples were analyzed. The mean AUC_0-last and AUC_0-∞ in patients who improved and died were (AUC_(0-last)=293 (152.97); AUC_(0-∞)=535.14 (353.67) and (AUC_(0-last)=137.19 (51.37); AUC_(0-∞)=582.12 (1036.09) respectively, the difference between the two outcome groups was not statistically significant (p=0.104). The pharmacokinetic model was best described by a two-compartment linear model. The goodness-of-fit plots showed that the final covariate pharmacokinetic model (having bodyweight and urinary creatinine clearance) adequately described the observed vancomycin concentrations.

Conclusions

Based on the finding of the study it was concluded that 1 g BD dosing of vancomycin is inappropriate. Including covariates such as urinary creatinine clearance and weight in the pharmacokinetic model helped predict drug concentrations more accurately. However, further studies are required to demonstrate efficacy regarding applying this strategy.

Asian Best Practices for Care of Diabetes in Elderly (ABCDE)

The elderly population with diabetes is diverse with the majority experiencing a decline in physical and mental capabilities, impacting the entire diabetes management process. Therefore, a need for geriatric-specific guidelines, especially for the Asian population, was identified and subsequently developed by an expert panel across government and private institutions from several Asian countries. The panel considered clinical evidence (landmark trials, position papers, expert opinions), recommendations from several important societies along with their decades of clinical experience and expertise, while meticulously devising thorough geriatric-specific tailored management strategies. The creation of the ABCDE best practices document underscores and explores the gaps and challenges and determines optimal methods for diabetes management of the elderly population in the Asian region.

A novel approach on water resource management with Multi-Criteria Optimization and Intelligent Water Demand Forecasting in Saudi Arabia

Ever-increasing demands for freshwater resources have elevated the likelihood of severe water stress in several places of Saudi Arabia during the last several decades. With effective decision-making processes, development objectives on water resource management emerge. In the following series of research articles, recent innovations in various objective demand forecasting systems are examined and contrasted in terms of their utility in resolving tough challenges in water resource management. Hence, this study proposes a novel approach to water resource management integrating Multi-Criteria Optimization and Intelligent Water Demand Forecasting (MCO-IWDF). This framework addresses the challenges in allocating various water resources to multiple water sectors in a future changing environment. In order to plan for future water needs, water managers use a variety of tools. When forecasting future water demand, the most common method is to estimate current per-capita consumption (gpcd) and multiply this by the expected population growth. Conserving water in the Kingdom of Saudi Arabia to improve irrigation issues. This research analyzes the current situation of available water resources and the water demand in Saudi Arabia. The machine intelligence and big data analytic approach improve the proposed water resource management scheme. The simulation analysis identifies the highest performance in demand prediction accuracy of 98.96% and optimization ratio of 97.87% compared to the existing models. Over time, a mathematical model is used to conduct simulation experiments. Studying the problem, creating a model and collecting data are just some of the steps involved in simulation research. Response analysis and a simulation report are also part of this process. The case study analysis results in a significant satisfactory level of 99.23%.

Familial hypercholesterolemia in community-based KHDC Nepal program-baseline data

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): HUG and Republic and Canton of Geneva – Service de solidarité internationaleBP Koirala Institute of Health Sciences

Familial hypercholesterolemia (FH) is either underdiagnosed or diagnosed after primary coronary events. Although homozygous variant of FH is considered rare, heterozygous FH is estimated to occur in about 1 in 200 to 300 individuals. There is no study pertaining to prevalence of FH in Nepal which could be a factor influencing cardiovascular morbidity and mortality.

We present a baseline data of FH in an ongoing in participants of community-based cardiovascular and kidney diseases preventive (KHDC Nepal) program in Mechinagar municipality in Eastern Nepal.

KHDC is a program to collaborate among health post, primary health center or equivalent, and local government along with community representatives created to educate, screen, and intervene for selective NCDs. This program is in alignment with the World Health Organization’s Package of Essential Noncommunicable (WHO PEN) disease interventions for primary health care in low-resource settings. General health status and lifestyle habits, physical examination, and blood pressure were assessed. Blood tests done included fasting lipid profile, serum creatinine, FBS, and HbA1c. A mechanism was developed to follow-up screened positive persons in the primary health centers. Referrals were made to the tertiary care center as needed.

We analyzed initial 7289 participants, 20 years or above, who were enrolled in KHDC program in the year 2020. We assessed for FH using Dutch Lipid Clinic Network(DLCN), Simon Broome and AHA criteria. Participants were categorized as definite, probable, possible, or no FH based on the scores of DLCN criteria; as definite and probable based on Simon Broome criteria and as clinically diagnosed FH based on AHA criteria.

The median age of the patient was 54 years, the majority being females (62.7%). A total of 70(0.96%) of the participants had elevated LDL-C levels of more than 190mg/dl detected during the screening and had no secondary cause for hyperlipidemia. According to DLCN criteria, 65(0.89%) participants were grouped under possible FH, 5(0.06%) were grouped under probable FH while none of them could be delineated as definite FH. According to Simon Broome criteria, 14(0.2%) participants were grouped under probable and none of them could be delineated as definite. According to AHA criteria, 10 (0.13%) participants were categorized as clinically diagnosed FH. DNA analysis was not available in our setup. Clinically manifested atherosclerotic disease was recorded in 5 participants. None of the participants were aware of the FH.

This community-based program of the adult population help create baseline data of FH in Nepal. Larger study with genetic analysis is likely to reveal true prevalence of FH in Nepal.

Critical Analysis of Existing Punjabi Grammar Checker and a Proposed Hybrid Framework Involving Machine Learning and Rule-Base Criteria

An important area of research involving Artificial Intelligence (AI) is Natural Language Processing (NLP). The objective of training a machine is to imitate and manipulate text and speech of humans. Progressive research is undertaken to find connection between humans and their usage of language commonly used being referred as Natural Language. Various tools for different languages have been developed for operating the natural languages widely used by public. NLP integrates various disciplines and works cohesively for processing text, Information Retrieval, AI etc. One such tool used for checking the accuracy of a given sentence in any language is referred to as a Grammar Checker. So a Grammar checker of a particular language explores grammatical errors (if any) and provide remedial suggestions for correction of the same. Such feature is imbibed by virtue of Natural Language Processing using Computational Linguistics. We have justified the need of an emerging Machine Learning technique by critically evaluating existing Punjabi Grammar checker that was developed earlier in light of certain real time cases. This process is accomplished by critically evaluating the output of each phase and identifying the component accountable for generating maximum errors and false alarms. Based on this analysis, we have proposed a hybrid framework as an efficient way of analyzing correction in sentences. This is attainable through the said booming technique of Machine Learning explicitly using Deep Neural Networks in combination with existing rule-based approach. It's a novel approach as no work using machine learning has been done earlier in Punjabi Grammar Checker.

MXenes based nano-heterojunctions and composites for advanced photocatalytic environmental detoxification and energy conversion: A review

Extensive research is being done to develop multifunctional advanced new materials for high performance photocatalytic applications in the field of energy production and environmental detoxification, MXenes have emerged as promising materials for enhancing photocatalytic performance owing to their excellent mechanical properties, appropriate Fermi levels, and adjustability of chemical composition. Numerous experimental and theoretical research works implied that the dimensions of MXenes have a significant impact on their performance. For photocatalysis to thrive in the future, we must understand the current state of the art for MXene in different dimensions. Using MXene co-catalysts in widely used in photocatalytic applications such as CO₂ reduction, hydrogen production and organic pollutant oxidation, this study focuses on the most recent developments in MXenes based materials, structural modifications, innovations in reaction and material engineering. It has been reported that using 5 mg of CdS-MoS₂-MXene researchers were able to generate as high as 9679 μmol/g/h hydrogen under visible light. The MXenes based heterojunction photocatalyst Co₃O₄/MXene was utilized to degrade 95% bisphenol A micro-pollutant in just 7 min. Numerous novel materials, their preparations and performances have been discussed. Depending upon the nature of MXene-based materials, the synthesis techniques and photocatalytic mechanism of MXenes as co-catalyst are also summarized. Finally, some final thoughts and prospects for developing highly efficient MXene-based photocatalysts are provided which will indeed motivate researchers to design novel hybrid materials based on MXenes for sustainable solutions to energy and pollution issues.

Numerical and Experimental Analysis of DVA on the Flexible-Rigid Rail Vehicle Carbody Resonant Vibration

This paper examines the influence of the equipment considered as a DVA (Dynamic Vibration Absorber) upon the mode of vertical vibrations of the car body in high-speed vehicles. The car body is represented as an Euler-Bernoulli beam to minimize flexible vibration. The DVA approach is used to find the appropriate suspension frequencies for various types of equipment. A vertical mathematical model with a flexible car body and equipment is developed to investigate the effect of equipment mass, suspension stiffness, damping, and mounting location on car-body flexible vibrations. A three-dimensional, rigid-flexible coupled vehicle system dynamics model is developed to simulate the car body and equipment's response to track irregularities. The experimental result was considered to verify the theoretical analysis and dynamic simulation. The mathematical analysis demonstrates that the DVA theory can be used to design the suspension parameters of the equipment and that it is suitable and effective in reducing the flexible vibration of the car body in which the vertical bending mode is greatly affected. Heavy equipment should be mounted as close to the car body's center as possible to achieve significant flexible vibration reduction, whereas light equipment contributes very little flexible vibration reduction.

MN/CA9 gene expression as a potential tumor marker for renal cell carcinoma

MN/CA9 is a cell surface glycoprotein and a tumor-associated antigen. It plays a crucial role in the regulation of cell proliferation and oncogenesis. There is no ideal tumor marker currently available for renal cell carcinoma (RCC) with sufficient sensitivity and specificity. Therefore, we studied MN/CA9 gene expression in the tumor tissue, apparently normal kidney tissue, preoperative blood, and urine samples of patients with RCC. We included thirty cases of renal tumors (26 RCC and 4 benign tumors) in the study. We applied an RT-PCR assay for MN/CA9 gene expression to 26 RCC kidney tumor samples and four benign kidney tumor tissue samples. We also evaluated MN/CA9 gene expression in preoperative blood and urine samples of 15 of these cases. Additionally, thirty-five grossly normal renal tissue samples, including 21 from kidneys with RCC, were also evaluated for gene expression. The RT-PCR analysis revealed that twenty-one out of 26 RCC tissue samples showed MN/CA9 gene expression compared to three out of 35 non-malignant renal tissue samples (p < 0.05). Two out of four benign renal tissue samples also expressed this gene. We also observed MN/CA9 gene expression in nine out of 15 blood samples and four out of 15 urine samples. All patients with urinary MN/CA9 gene expression showed expression in blood and tumor tissue samples. We found a correlation in terms of MN/CA9 expression between blood and tumor tissue samples of RCC patients as those who exhibit MN/CA9 expression in blood were also positive at the tumor tissue levels. The difference in MN/CA9 gene expression in tumor tissue, blood, and urine samples in relation to the stage of the disease, nuclear grade, and histological cell-type was not statistically significant. However, all the three patients who had metastatic RCC had MN/CA9 gene expression in their blood. The existence of a tumor-associated antigen such as MN/CA9 may present a possible target for molecular diagnosis and management of RCC.

Empirical research on sustainable developmental goals and priorities for water sustainability in Saudi Arabia

Saudi Arabia is dry and devoid of permanent water sources. Saudi Arabia's desalination plants, which provide drinkable water, rely on its oil reserves. It is one of the world's driest countries, but its population uses fresh water at a third rate. Therefore, the most crucial step is to alter people's behavior by using water more efficiently and intelligently by adopting water conservation techniques. Through adopting a strategic water strategy, the Saudi government has simplified the regulatory system in the water sector. It examines the most effective ways to generate and control water through its water policy. This research aims to forecast the water consumption required for different sectors until 2030 in Saudi Arabia and designed an intelligent Water Resource Demand Forecasting (iWRDF) model. This model used the internet of things (IoT) and big data analytics (BDA) in demand forecasting. The experimental outcomes outperform the proposed model with an accuracy of 96.86% than the existing models. Furthermore, this model helps find sustainable developmental goals and priorities for water sustainability in Saudi Arabia.

Machine learned hybrid Gaussian analysis of COVID-19 pandemic in India

This article discusses short term forecasting of the Novel Corona Virus (COVID -19) data for infected, recovered and active cases using the Machine learned hybrid Gaussian and ARIMA method for the spread in India. The Covid-19 data is obtained from the World meter and MOH (Ministry of Health, India). The data is analyzed for the period from January 30, 2020 (the first case reported) to October 15, 2020. Using ARIMA (2, 1, 0), we obtain the short forecast up to October 31, 2020. The several statistics parameters have tested for the goodness of fit to evaluate the forecasting methods but the results show that ARIMA (2, 1, 0) gives better forecast for the data system. It is observed that COVID 19 data follows quadratic behavior and in long run it spreads with high peak roughly estimated in September 18, 2020. Also, using nonlinear regression it is observed that the trend in long run follows the Gaussian mixture model. It is concluded that COVID 19 will follow secondary shock wave in the month of November 2020. In India we are approaching towards herd immunity. Also, it is observed that the impact of pandemic will be about 441 to 465 days and the pandemic will end in between April-May 2021. It is concluded that primary peak observed in September 2020 and the secondary shock wave to be around November 2020 with sharp peak. Thus, it is concluded that the people should follow precautionary measures and it is better to maintain social distancing with all safety measures as the pandemic situation is not in control due to non-availability of medicines.

Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal

SETTING

There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.

OBJECTIVE

To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.

DESIGN

This was a cross-sectional study using secondary laboratory data.

RESULTS

Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.

CONCLUSION

Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.

Guided and unguided de-escalation from potent P2Y12 inhibitors among patients with ACS: a meta-analysis

Background

Dual antiplatelet therapy (DAPT) with a potent P2Y12 inhibitor is recommended in patients with acute coronary syndrome (ACS) and should be tailored according to ischemic and bleeding risks, which are highest in the acute phase, and gradually attenuate overtime. De-escalation strategies of DAPT aim to optimize this balance of risks.

Purpose

We compared guided or unguided DAPT de-escalation strategies from potent P2Y12 inhibitors to either clopidogrel or lower doses of potent P2Y12 inhibitors versus standard DAPT with potent P2Y12 inhibitors among patients with ACS.

Methods

PubMed, Google Scholar and Cochrane Central Register of Controlled Trials were searched from inception till March 10th 2021. 1633 records were screened on DAPT de-escalation strategies after ACS for inclusion. Aspirin monotherapy and non-randomized trials were excluded.

The primary endpoint was BARC ≥2 bleeding. Other endpoints included MACE (defined according to the definitions reported in the original study protocols), all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, and stroke. Hazard ratios (HRs) and 95% CIs were used as metric of choice for treatment effects with random-effects models. Heterogeneity was assessed with the I2 index. We assessed the interaction between de-escalation strategy (guided vs. unguided) and treatment with a random-effects meta-regression analysis with the empirical Bayes method. This study has been submitted to PROSPERO for registration.

Preliminary findings

Four randomised trials and a total of 8,082 patients randomly allocated to a de-escalation strategy (genetic guided to clopidogrel, n=1,242; platelet function guided to clopidogrel, n=1,304; unguided to clopidogrel (n=323); unguided to lower dose, n=1,170) or standard DAPT (n=4,043) were included in our analysis. De-escalation strategy had a reduction in BARC ≥2 bleeding (HR 0.57, 95% CI 0.37–0.89; I2=81%). MACE (HR 0.79, 95% CI 0.62–1.02; I2=0%), all-cause death (HR 0.89, 95% CI 0.58–1.36), cardiovascular death (HR 0.63, 95% CI 0.36–1.10; I2=0%), myocardial infarction (HR 0.81, 95% CI 0.56–1.17; I2=0%), stent thrombosis (HR 0.57, 95% CI 0.19–1.74; I2=0%) and stroke (HR 0.73, 95% CI 0.39–1.35; I2=0%) did not differ between patients with a de-escalation strategy and those without. Meta-regression analysis did not show any significant interaction between de-escalation method (guided vs. unguided) and treatment effects, except for BARC ≥2 bleeding (P interaction = 0.070), suggesting a greater reduction with unguided de-escalation.

Conclusion

A de-escalation strategy of DAPT after ACS was associated with a lower number of clinically relevant bleeding events, mostly in patients who underwent unguided de-escalation, while no association with increased ischemic events was found. However, the observed broad confidence intervals limit the certainty of our findings.

Funding Acknowledgement

Type of funding sources: None. BARC ≥2 bleedingMACE

Ticagrelor monotherapy after percutaneous coronary intervention in patients with concomitant diabetes mellitus and chronic kidney disease: a TWILIGHT substudy

Background

Diabetes mellitus (DM) and chronic kidney disease (CKD) are established risk factors for cardiovascular events, with patients presenting both conditions being at extremely high risk. P2Y12 inhibitor monotherapy with ticagrelor after a short course of dual antiplatelet therapy has emerged as a bleeding avoidance strategy for high-risk patients undergoing percutaneous coronary intervention (PCI).

Purpose

To investigate ischemic and bleeding outcomes associated with ticagrelor monotherapy versus ticagrelor plus aspirin according to the presence or absence of CKD and DM.

Methods

The TWILIGHT trial enrolled patients undergoing PCI with a drug-eluting stent who fulfilled at least one clinical and one angiographic high-risk criterion. Both DM and CKD (estimated glomerular filtration rate &lt;60 mL/min/1.73m2) were clinical study entry criteria. Following 3 months of ticagrelor plus aspirin, patients who had been adherent to treatment and free from major adverse events were randomly assigned to either aspirin or placebo in addition to ticagrelor for 1 year. The primary endpoint was Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding. The key secondary endpoint was the composite of all-cause death, myocardial infarction, or stroke. Net adverse clinical events (NACE) were defined as BARC type 3 or 5 bleeding, all-cause death, myocardial infarction, or stroke.

Results

Of the 6273 patients included in the analysis, 8.0% had both CKD and DM (DM+/CKD+), 8.9% had CKD only (DM-/CKD+), 29.0% had DM only (DM+/CKD-), and 52.1% had neither CKD nor DM (DM-/CKD-). At 1-year follow-up, there was a progressive increase in the rates of bleeding and ischemic events according to DM and CKD status (Figure 1). Ticagrelor plus placebo reduced the primary bleeding endpoint as compared with ticagrelor plus aspirin across all study groups, including DM+/CKD+ patients (4.7% vs. 8.7%; HR 0.52, 95% CI 0.25–1.07), with no evidence of heterogeneity (p-interaction=0.68). Similar treatment effects of ticagrelor monotherapy were observed for major BARC type 3 or 5 bleeding (p-interaction=0.17), with DM+/CKD+ patients showing the greatest absolute risk reduction (0.9% vs. 5.1%; HR 0.16, 95% CI 0.04–0.72). The key secondary endpoint was not significantly different between treatment arms across study groups, with the exception of a reduced risk in DM+/CKD- patients receiving ticagrelor monotherapy (p-interaction=0.033). A similar pattern in the DM+/CKD- group was observed for NACE (p-interaction=0.030) (Figure 2).

Conclusions

Among high-risk patients undergoing PCI, ticagrelor monotherapy reduced the risk of clinically relevant and major bleeding without a significant increase in ischemic events as compared with ticagrelor plus aspirin, irrespective of the presence of DM and CKD. Furthermore, ticagrelor monotherapy seemed to be associated with a more favourable net benefit in patients with DM without CKD.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Investigator-initiated grant from AstraZeneca Figure 1. Event rates according to DM/CKD statusFigure 2. Effects of ticagrelor monotherapy

Improved water resource management framework for water sustainability and security

The water resource is an essential field of economic growth, social progress, and environmental integrity. A novel solution is offered to meet water needs, distribution, and IoT-based quality management requirements. With technological growth, this paper presents an IoT-enabled Water Resource Management and Distribution Monitoring System (IWRM-DMS) using sensors, gauge meters, flow meters, ultrasonic sensors, motors to implement in rural cities. Thus, research proposes that the IWRM-DMS establish the rural demand for water and the water supply system to minimize water demand. The system proposed includes different sensors, such as the water flow sensor, the pH sensor, the water pressure valve, the flow meters, and ultrasound sensors. This water system has been developed, which addresses the demand for domestic water in the village. Machine Intelligence has been designed for demand prediction in the decision support system. The simulation results confirm the applicability of the proposed framework in real-time environments. The proposed IWRM-DMS has been proposed to analyse the water quality to ensure water distribution in a rural area to achieve less MAPE (21.41%) and RMSE(15.12%), improve efficiency (96.93%), Reliability (98.24%), enhance prediction (95.29%)), the overall performance (97.34%), moisture content ratio (7.4%), cost-effectiveness ratio (95.7%) when compared to other popular methods.

Energy and carbon budgeting of traditional land use change with groundnut based cropping system for environmental quality, resilient soil health and farmers income in eastern Indian Himalayas

Energy intensive traditional cereals based monoculture often lead to high greenhouse gas emissions and degradation of land and environmental quality. Present study aimed at evaluating the energy and carbon budget of diversified groundnut (Arachis hypogea L) based cropping system with over existing traditional practice towards the development of a sustainable production technology through restoration of soil and environmental quality and enhancement of farming resiliency by stabilizing farmers' income. The trials comprised of three introduced groundnut based systems viz. groundnut- pea (Pisum sativum), groundnut-lentil (Lens esculenta) and groundnut-toria (Brasssica campestris var. Toria) replacing three existing systems viz. maize (Zea mays L) - fallow, maize - toria, and rice (Oryza sativa L)-fallow systems. Four years study revealed that adoption of groundnut based systems reduced non-renewable energy input use (fertilizers, chemical, machinery and fossil fuels) by 25.5%, consequently that reduced the cost of production. Repeated analysis of variance measurement also affirmed that groundnut based systems (groundnut-pea>groundnut-lentil> groundnut-toria) increased the energy use efficiency, energy productivity, carbon use efficiency, net returns and decreased the specific energy and energy intensiveness. Groundnut based systems increased the mean system productivity and water productivity in terms of groundnut equivalent yield by 3.7 and 3.1 folds over existing practice. The savings of fossil fuel reduced greenhouse gas emissions owing to reduced use of farm machinery and synthetic fertilizers. Groundnut based systems significantly (p < 0.05) enhanced the soil carbon concentration (8.7-18.1%) and enzymatic activities (27.1-51.8%) over existing practice. Consequently, estimated soil quality index values were 35.9-77.3% higher under groundnut based systems than existing practice. Thus, the study indicated the resilient nature of groundnut based systems as an environmentally safe and sustainable production technology for enhancing resource use efficiency, reduce carbon emission, energy intensiveness and cost of production in the Eastern Himalaya region of India and similar ecosystems.

IoT-based analysis for controlling & spreading prediction of COVID-19 in Saudi Arabia

Presently, novel coronavirus outbreak 2019 (COVID-19) is a major threat to public health. Mathematical epidemic models can be utilized to forecast the course of an epidemic and cultivate approaches for controlling it. This paper utilizes the real data of spreading COVID-19 in Saudi Arabia for mathematical modeling and complex analyses. This paper introduces the Susceptible, Exposed, Infectious, Recovered, Undetectable, and Deceased (SEIRUD) and Machine learning algorithm to predict and control COVID-19 in Saudi Arabia.This COVID-19 has initiated many methods, such as cloud computing, edge-computing, IoT, artificial intelligence. The use of sensor devices has increased enormously. Similarly, several developments in solving the COVID-19 crisis have been used by IoT applications. The new technology relies on IoT variables and the roles of symptoms using wearable sensors to forecast cases of COVID-19. The working model involves wearable devices, occupational therapy, condition control, testing of cases, suspicious and IoT elements. Mathematical modeling is useful for understanding the fundamental principle of the transmission of COVID-19 and providing guidance for possible predictions. The method suggested predicts whether COVID-19 would expand or die in the long term in the population. The mathematical study results and related simulation are described here as a way of forecasting the progress and the possible end of the epidemic with three forms of scenarios: 'No Action,' 'Lockdowns and New Medicine.' The lock case slows it down the peak by minimizing infection and impacts area equality of the infected deformation. This study familiarizes the ideal protocol, which can support the Saudi population to breakdown spreading COVID-19 in an accurate and timely way. The simulation findings have been executed, and the suggested model enhances the accuracy ratio of 89.3%, prediction ratio of 88.7%, the precision ratio of 87.7%, recall ratio of 86.4%, and F1 score of 90.9% compared to other existing methods.

Nonlinear dynamics for the spread of pathogenesis of COVID-19 pandemic

Coronaviruses did not invite attention at a global level and responsiveness until the series of 2003-SARS contagion followed by year-2012 MERS plus, most recently, 2019-nCoV eruptions. SARS-CoV & MERS-CoV are painstaking, extremely pathogenic. Also, very evidently, both have been communicated from bats to palm-civets & dromedary camels and further transferred ultimately to humans. No country has been deprived of this viral genomic contamination wherever populaces reside and are interconnected. This study aimed to develop a mathematical model for calculating the transmissibility of this viral genome. The analysis aids the study of the outbreak of this Virus towards the other parts of the continent and the world. The parameters such as population mobility, natural history, epidemiological characteristics, and the transmission mechanism towards viral spread when considered into crowd dynamism result in improved estimation. This article studies the impact of time on the amount of susceptible, exposed, the infected person taking into account asymptomatic and symptomatic ones; recovered i.e., removed from this model and the virus particles existing in the open surfaces. The transition from stable phase to attractor phase happens after 13 days i.e.; it takes nearly a fortnight for the spread to randomize among people.

Further, the pandemic transmission remains in the attractor phase for a very long time if no control measures are taken up. The attractor-source phase continues up to 385 days i.e., more than a year, and perhaps stabilizes on 386th day as per the Lyapunov exponent's analysis. The time series helps to know the period of the Virus's survival in the open sources i.e. markets, open spaces and various other carriers of the Virus if not quarantined or sanitized. The Virus cease to exist in around 60 days if it does not find any carrier or infect more places, people etc. The changes in LCEs of all variables as time progresses for around 400 days have been forecasted. It can be observed that phase trajectories indicate how the two variables interact with each other and affect the overall system's dynamics. It has been observed that for exposed and asymptomatically infected (y–z), as exposed ones (y) change from 0 to 100 the value of asymptomatically infected (z) increased upto around 58, at exposed ones (y) = 100, asymptomatically infected (z) has two values as 58 and 10 i.e. follows bifurcation and as exposed ones (y) changes values upto 180, the value of asymptomatically infected (z) decreases to 25 so for exposed ones (y) from 100 to 180, asymptomatically infected (z) varies from 58 to 25 to 10 follows bifurcation. Also, phase structures of exposed-symptomatically infected (y–u), exposed-removed (y–v), exposed-virus in the reservoir (y–w), asymptomatically infected-removed (z–v), symptomatically infected-removed (u–v) specifically depict bifurcations in various forms at different points. In case of asymptomatically infected-virus in the reservoir (z–w), at asymptomatically infected (z) = 10, the value of viruses in the reservoir (w) = 50, then as asymptomatically infected (z) increases to upto around 60. At this point, removed ones (v) increase from 50 to 70 and asymptomatically infected (z) decrease to 20 i.e., crosses the same value twice, which shows its limiting is known as limit cycle behavior and both the values tend to decrease towards zero. It shows a closed-loop limit cycle. Today, there has been no scientific revolution in the development of vaccination, nor has any antiviral treatment been successful, resulting in lack of its medication. Based on the phases, time series, and complexity analysis of the model's various parameters, it is studied to understand the variation in this pandemic's scenario.

Morpho-molecular and mating-type locus diversity of Ustilaginoidea virens: an incitant of false smut of rice from Southern parts of India

AIMS

To characterize the geo-distinct isolates of Ustilaginoidea virens for morpho-molecular and mating-type locus diversity.

METHODS AND RESULTS

Sixty-one isolates of U. virens collected from Southern India exhibited significant diversity in mycelial width (3·45-5·50 µm), colony colour (yellow, pale yellow, and white), and growth pattern (thick leather mat, raised-fluffy, flat-fluffy, and raised). Field-borne chlamydospores of each isolate were significantly smaller in size (3·34-5·26 µm² ) compared to those formed on culture media (18·6-100·89 µm² ). The phylogenetic study based on internal transcribed sequences revealed two clusters; however, most isolates (n = 54) were grouped in cluster-I, indicating common ancestral origin. We also identified 42 haplotypes; among them, Hap_3 has the highest number of isolates (n = 19). Mating-type locus (MAT1) analysis revealed all sixty-one isolates as heterothallic, wherein 37 and 24 isolates belonging to MAT1-1-1 and MAT1-2-1 heterothallic mating types, respectively. The microsynteny analysis of MAT1 loci of one of the Indian strain (Uv-Gvt) along with Uv-8b (China) strain revealed synteny conservation at MAT1 locus, which is flanked by conserved genes SLA2 and a hypothetical protein in the upstream and APN2, COX12 and APC5 in the downstream of the locus.

CONCLUSIONS

Morpho-molecular study revealed the significant diversity among geo-distinct isolates, and MAT1 loci analysis indicated the distribution of heterothallic mating types in south Indian paddy fields. And also, complete synteny conservation between Indian and Chinese strain was observed at the MAT1 locus.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report describing the sexuality of Indian strains of the U. virens, which would help better understand the genetic diversity of the U. virens prevailing in Southern India and aid in developing resistant rice cultivars against this pathogen population.

Role of free volumes and segmental dynamics on ion conductivity of PEO/LiTFSI solid polymer electrolytes filled with SiO2 nanoparticles: a positron annihilation and broadband dielectric spectroscopy study

The limited ionic conductivity of polymer electrolytes is a major issue for their industrial application. Enhancement of ionic conductivity in the poly(ethylene oxide), PEO, based electrolyte has been achieved by loading passive nanofillers such as SiO₂ nanoparticles (NPs). To investigate the role of modifications in free volume characteristics and the polymer chain dynamics induced by the loading of passive fillers on the ionic conductivity of the PEO based ternary electrolyte, a systematic investigation has been carried out using positron annihilation and broadband dielectric spectroscopy. As a result of interfacial interactions, the loading of SiO₂ NPs alters the semi-crystalline morphology of PEO resulting in a higher crystallinity at lower loadings due to the surface confinement of PEO chains, and the formation of smaller PEO crystallites at higher loadings due to interparticle nanoconfinement. These modifications are accompanied by a decrease in free volume fraction at the lowest loading (0.5 wt%) followed by an increase at higher loadings (≥2.0 wt%). The Almond-West formalism considering two different universalities in different temperature and frequency ranges has been used to explain the ion-conduction process at different NP loadings. The Li ion conductivity is observed to be maximum for a 5.0 wt% loading of SiO₂ NPs. The enhancement in ionic conductivity is observed to be directly correlated with the free volume characteristics and segmental dynamics of the PEO matrix, confirming their role in ion transport in polymer electrolytes.

Computational exploration and anti-mycobacterial activity of potential inhibitors of Mycobacterium tuberculosis acetyl coenzyme A carboxylase as anti-tubercular agents

Acetyl Coenzyme A Carboxylase (AccD6) is a homodimeric protein which is involved in the carboxylation of acetyl coenzyme A to produce malonyl coenzyme A, which plays an important role in the biosynthesis of fatty acid chain. However, studies suggest that AccD6 in combination with AccA3 produces malonyl co-A. Certain herbicides are known to inhibit plant ACC. Among these herbicides, haloxyfop was found to inhibit AccD6 at IC50 of 21.1 ± 1 µM. In this study, we have performed molecular docking of the Maybridge database consisting of ~55,000 compounds in the active site of the protein with haloxyfop as a reference molecule, followed by molecular dynamics study and biological activity determination of prioritized compounds. Out of the nine compounds selected for biological evaluation, three compounds - CD07230, HTS08529 and KM08871 - were found to exhibit anti-mycobacterial activity.

Silicate glass matrix@Cu2O/Cu2V2O7 p-n heterojunction for enhanced visible light photo-degradation of sulfamethoxazole: High charge separation and interfacial transfer

Focusing on the treatment of pharmaceuticals contaminated water by advanced oxidation processes, a novel three dimensional silicate glass matrix (3-DG) coupled Cu₂O/Cu₂V₂O₇ p-n heterojunction was constructed by in-situ hydrothermal technique. The optimal Cu₂O/Cu₂V₂O₇ with 30 wt % Cu₂V₂O₇ (CV-30) degrades 90.1 % sulfamethoxazole (SMX) in 60 min and nearly 100 % removal in 45 min via coupling with 3-DG. Under natural sunlight ∼ 80 % SMX removal was observed. The internal electric field of the p-n junction facilitates the electron flow via the interface. 3-D silicate glass increases the visible light absorption dramatically via internal reflection which facilitates higher exposure for the junction and shortens the diffusion length of charge carriers. The effect of reaction parameters suggests that HCO₃^- and CO₃^2- ions substantially escalate the SMX removal rate. Scavenging experiments and ESR probe suggest O₂^- as the main active species followed by OH radicals. The degradation products were detected by LC-MS analysis and a degradation mechanism was also predicted. The photocatalytic mechanism was explained in terms of the electron transfer facilitated by conventional transfer and Z-scheme. This strategy to construct such highly visible and solar active p-n heterojunctions will pave way for future opportunities for the degradation of recalcitrant pharmaceutical pollutants.

Coronin-1 levels in patients with tuberculosis

Background & objectives:

Despite advances in diagnostics and therapeutics, tuberculosis (TB) is widely prevalent and contributes to a significant burden of illness in both developing and developed nations. The present study was aimed to assess the role of coronin in TB patients and healthy controls. Coronin is a leucocyte-specific protein that is actively recruited in mycobacterial phagolysosomes, where it inhibits lysosomal delivery of Mycobacterium by activating a calcium-dependent phosphatase-calcineurin.

Methods:

In the study, 100 newly diagnosed cases of TB (pulmonary and extra-pulmonary) and healthy controls were prospectively enrolled over one year and the levels of coronin-1a in these patients and controls were measured by quantitative PCR (qPCR).

Results:

A total of 100 TB patients and 100 healthy individuals as controls were assessed. There were 59 patients with extra-pulmonary TB (EPTB) and 41 of pulmonary TB (PTB). In 47 per cent of patients, corroborative histopathological evidence of TB was also available. Significantly higher values of coronin-1a were observed in TB patients (19.94±2.61) than in healthy controls (16.09±1.91) (P<0.001).

Interpretation & conclusions:

Coronin 1a appears to play an important role in the TB disease pathophysiology and agents developed against coronin may have a role in the treatment of TB. Further studies are required to assess if coronin-1a levels are elevated in non-tubercular infective a etiologies and whether these can be a potential drug target in patients with TB.

Optimizing the treatment of newly diagnosed type 2 diabetes mellitus with combination of dipeptidyl peptidase-4 inhibitors and metformin: An expert opinion

The expanding burden of Type 2 Diabetes Mellitus (T2DM) in today's world, with respect to incidence, prevalence, and cost incurred, is an existential risk to society. Various guidelines recommend individualization of treatment. This expert opinion aims to review the recent evidences and reach a consensus on the preferable combination therapy for use in newly diagnosed Indian T2DM patients with HbA_1C >7.5%. The core committee included seventeen diabetes specialists. Three statements were developed, discussed, and rated by specialists and recommendations were noted. Specialists were requested to rate the statements using a 9-point Likert's scale with score of 1 being “Strongly Disagree” and 9 being “Strongly Agree”. Statement-specific scores of all the specialists were added and mean score of ≥7.00 was considered to have achieved a consensus. Statements used to meet the consensus were: Statement 1. Majority of newly-diagnosed Indian diabetics have HbA_1C >7.5%; Statement 2. Patients with HbA_1C >7.5% may be initiated with dual therapy of dipeptidyl peptidase-4 inhibitors (DPP4Is) + Metformin; and Statement 3. In Indian patients with HbA_1C >7.5% at diagnosis, DPP4Is + Metformin may be considered as a first-line therapy. Literature review revealed that HbA_1C level at the time of diagnosis in majority of Indian T2DM patients is >7.5%. Consensus was reached that dual anti-diabetic therapy should be initiated in patients with HbA_1C >7.5%. DPP4Is + Metformin is the preferred cost-effective option and may be considered as a first-line therapy in Indian T2DM patients with HbA_1C >7.5% at diagnosis.

A deep neural network for estimating the bladder boundary using electrical impedance tomography

OBJECTIVE

Accurate bladder size estimation is an important clinical parameter that assists physicians, enabling them to provide better treatment for patients who are suffering from urinary incontinence. Electrical impedance tomography (EIT) is a non-invasive medical imaging method that estimates organ boundaries assuming that the electrical conductivity values of the background, bladder, and adjacent tissues inside the pelvic domain are known a priori. However, the performance of a traditional EIT inverse algorithm such as the modified Newton-Raphson (mNR) for shape estimation exhibits severe convergence problems as it heavily depends on the initial guess and often fails to estimate complex boundaries that require greater numbers of Fourier coefficients to approximate the boundary shape. Therefore, in this study a deep neural network (DNN) is introduced to estimate the urinary bladder boundary inside the pelvic domain.

APPROACH

We designed a five-layer DNN which was trained with a dataset of 15 subjects that had different pelvic boundaries, bladder shapes, and conductivity. The boundary voltage measurements of the pelvic domain are defined as input and the corresponding Fourier coefficients that describe the bladder boundary as output data. To evaluate the DNN, we tested with three different sizes of urinary bladder.

MAIN RESULTS

Numerical simulations and phantom experiments were performed to validate the performance of the proposed DNN model. The proposed DNN algorithm is compared with the radial basis function (RBF) and mNR method for bladder shape estimation. The results show that the DNN has a low root mean square error for estimated boundary coefficients and better estimation of bladder size when compared to the mNR and RBF.

SIGNIFICANCE

We apply the first DNN algorithm to estimate the complex boundaries such as the urinary bladder using EIT. Our work provides a novel efficient EIT inverse solver to estimate the bladder boundary and size accurately. The proposed DNN algorithm has advantages in that it is simple to implement, and has better accuracy and fast estimation.

222Rn Exhalation Flux Rate and 226Ra in the Soils of a Copper-Mineralised Area

Uranium-series radionuclides exist in trace quantities in all soils and rocks on earth in variable concentrations. Among these, 222Rn gas exhaled by the soil of a geological location is the main contributor to the environmental radioactivity. A 222Rn exhalation flux study was carried out in the heavily mineralised area of the Singhbhum Copper Belt of Jharkhand, India. A significant seasonal variation in the soil gas exhalation was observed, which is attributable to the seasonal atmospheric parameters of the study area. The average 222Rn exhalation flux from the soil was estimated to be in the range of 4.5-$20.1\ \mathrm{Bq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$ with a mean of $10.1\pm 3.9\ \mathrm{mBq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$ and geometric mean (GM) of $9.5\ \mathrm{mBq}\ {\mathrm{m}}^{-2}\ {\mathrm{s}}^{-1}$. Also, 20 soil samples collected from the study area were analysed by the emanometric method, which estimated the 226Ra specific activity in the soils in the range of 9-$63\ \mathrm{Bq}\ \mathrm{k}{\mathrm{g}}^{-1}$ and a mean value of $39\pm 16\ \mathrm{Bq}\ \mathrm{k}{\mathrm{g}}^{-1}$.