Fetal Appendiceal Perforation Masquerading as Meconium Peritonitis: A Report of a Rare Case.

Intrauterine appendicular perforation leading to meconium peritonitis is exceptionally rare, with few reported cases in the literature. This case underscores the diagnostic challenges and high mortality associated with neonatal appendicular perforation. Neonatal appendicitis and subsequent perforation are uncommon due to the funnel shape of the fetal appendix, which reduces susceptibility to luminal obstruction. While advances in neonatal care and diagnostic modalities have improved outcomes, challenges persist in timely diagnosis and management. We present the case of a preterm infant, one of dichorionic-diamniotic (DCDA) twins delivered via cesarean section, who developed gross abdominal distension and respiratory distress shortly after birth. Diagnostic abdominocentesis revealed meconium-stained fluid, prompting further investigation with imaging and subsequent exploratory laparotomy. Extensive adhesions and cecal perforation were observed, necessitating a cecostomy. Despite interventions, the infant's condition deteriorated, leading to a fatal outcome. Intrauterine appendicular perforation leading to meconium peritonitis is a rare and difficult-to-diagnose condition. Antenatal suspicion and early surgical intervention are crucial for improving outcomes. Factors contributing to neonatal appendicular perforation include ischemia, obstruction, and infective etiologies. Neonatal appendicular perforation is a rare but life-threatening condition requiring a high index of suspicion for prompt diagnosis and management. Advances in diagnostic tools and antenatal monitoring have contributed to improved outcomes, highlighting the importance of considering this diagnosis in cases of unexplained neonatal abdominal distension.

NeighBERT: Medical Entity Linking Using Relation-Induced Dense Retrieval.

One of the common tasks in clinical natural language processing is medical entity linking (MEL) which involves mention detection followed by linking the mention to an entity in a knowledge base. One reason that MEL has not been solved is due to a problem that occurs in language where ambiguous texts can be resolved to several named entities. This problem is exacerbated when processing the text found in electronic health records. Recent work has shown that deep learning models based on transformers outperform previous methods on linking at higher rates of performance. We introduce NeighBERT, a custom pre-training technique which extends BERT (Devlin et al [1]) by encoding how entities are related within a knowledge graph. This technique adds relational context that has been traditionally missing in original BERT, helping resolve the ambiguity found in clinical text. In our experiments, NeighBERT improves the precision, recall, and F1-score of the state of the art by 1-3 points for named entity recognition and 10-15 points for MEL on two widely known clinical datasets. Supplementary Information: The online version contains supplementary material available at 10.1007/s41666-023-00136-3.

Cardiac defects of hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders: a retrospective cohort study.

Background: Defective connective tissue structure may cause individuals with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD) to develop cardiac defects. Methods: We conducted a retrospective chart review of adult patients treated in the EDS Clinic from November 1, 2019, to June 20, 2022 to identify those with cardiac defects. Echocardiogram data were collected using a data collection service. All EDS Clinic patients were evaluated by a single physician and diagnosed according to the 2017 EDS diagnostic criteria. Patient demographic, family and cardiac history were extracted from self-reported responses from a REDCap clinical intake questionnaire. Patients with at least 1 available echocardiogram (ECHO) were selected for the study (n = 568). Results: The prevalence of aortic root dilation in patients with hEDS was 2.7% and for HSD was 0.6%, with larger measurements for males than females and with age. Based on self-reported cardiac history that was verified from the medical record, patients with hEDS with bradycardia (p = 0.034) or brain aneurysm (p = 0.015) had a significantly larger average adult aortic root z-score. In contrast, patients with HSD that self-reported dysautonomia (p = 0.019) had a significantly larger average aortic root z-score. The prevalence of diagnosed mitral valve prolapse in patients with hEDS was 3.5% and HSD was 1.8%. Variants of uncertain significance were identified in 16 of 84 patients that received genetic testing based on family history. Conclusions: These data reveal a low prevalence of cardiac defects in a large cohort of well-characterized hEDS and HSD patients. Differences in cardiovascular issues were not observed between patients with hEDS vs. HSD; and our findings suggest that cardiac defects in patients with hEDS or HSD are similar to the general population.

Characterization of excavated plastic waste from an Indian dumpsite: Investigating extent of degradation and resource recovery potential.

In recent years, the concept of landfill mining has gained a lot of traction in India, and tonnes of plastic waste is being excavated. The present shift towards a circular economy necessitates to explore the use of excavated plastic waste as a source of valuable materials and energy. However, the physicochemical characteristics of plastic waste change due to the degradation and weathering process in landfills, making its valorization difficult. The current study investigates the change in physicochemical characteristics of plastic waste with age from an Indian dumpsite to identify the potential valorization options. In addition, a material and energy flow analysis was performed considering incineration treatment of plastic waste. The plastic waste ranged between 3.6 and 21% in the dumpsite and has almost doubled in recent decades, owing to the increase in plastic waste generation in India. Polyethylene (high- and low-density) accounted for approximately 66% of the excavated plastic waste and had a lot of adhered surface impurities. Mechanical pre-treatment using a shredder was effective in the removal of the adhered impurities with a recovery rate of 50-70% for polyethylene and a higher recovery of 70-90% for other types of plastic. Changes in the surface morphology of plastic waste with aging were observed through Scanning Electron Microscopy. The Fourier Transform Infrared Spectroscopy results confirmed low degradation levels for aged plastic waste, which is also confirmed through the high level of oxygen detected. The material and energy flow analysis revealed that incinerating one tonne of excavated plastic waste could produce approximately 1410 kWh of electricity.

A Prototype System for High Frame Rate Ultrasound Imaging based Prosthetic Arm Control.

The creation of unique control methods for a hand prosthesis is still a problem that has to be addressed. The best choice of a human-machine interface (HMI) that should be used to enable natural control is still a challenge. Surface electromyography (sEMG), the most popular option, has a variety of difficult-to-fix issues (electrode displacement, sweat, fatigue). The ultrasound imaging-based methodology offers a means of recognising complex muscle activity and configuration with a greater SNR and less hardware requirements as compared to sEMG. In this study, a prototype system for high frame rate ultrasound imaging for prosthetic arm control is proposed. Using the proposed framework, a virtual robotic hand simulation is developed that can mimic a human hand as illustrated in the link: https://youtu.be/LBcwQ0xzQK0. The proposed classification model simulating four hand gestures has a classification accuracy of more than 90%.Clinical relevance-The proposed system enables an ultrasound imaging based human machine interface that can be a research and development platform for novel control strategies of a hand prosthesis.

A novel technique of schedule tracker for parabolic dish concentrator.

Tracking is important in a system that harnesses solar energy. Single axis tracking mechanism is cheaper and simple to develop but because of the limitation of tracking axis, this system is less efficient than dual axis. Dual-axis tracking systems necessitate a large number of equipment, sensors, motors, and a lengthy computer program to function properly. Therefore, in the present study, a novel method of solar tracking has been discussed where each tracking point has the impact of both the azimuth and altitude angle at a single point. This method is an average axis tracking method (AATM). HelioScope software was used to extract the hourly solar altitude and azimuth angles for each day and month for the site of Bhopal, India. The average method was then used to get the hourly average solar tracking angle (ASTA) for each month. The parabolic dish concentrator was designed in SolidWorks to apply and simulate the newly developed tracking points on SolTrace software. The graphical analysis was presented along with proper validation of the proposed method, and the single and dual axes were compared with AATM. The graphical study shows that the average axis tracking points have a smoother slop of wave than the single axis. From June to September, the proposed method's error was estimated between 0.85 and 0.95. It can be concluded that by making slight adjustments to the seasonal angle, this error could be minimized and the concept could be successfully applied to a parabolic dish or a solar PV system.

Stroke and kidney transplantation.

PURPOSE OF REVIEW: This review will focus on the epidemiological data, risk factors, and management of stroke before and after kidney transplant. Stroke is highly prevalent in waitlisted patients as well as kidney transplant recipients and is associated with impaired transplant outcomes. Multiple traditional, nontraditional, and transplanted risk factors increase the risk of stroke. RECENT FINDINGS: Although the risk of stroke is reduced after kidney transplantation compared with remaining on dialysis, the morbidity and mortality from stroke after transplantation remain significant. SUMMARY: Early screening for risk factors before and after a kidney transplant and following the Kidney Disease Improving Global Outcomes (KDIGO) management guidelines could minimize the incidence of stroke and transplant outcomes.

Physicochemical and biological assessment of legacy waste for application as soil conditioner.

The study examines the recycling potential of fine fraction obtained from dumpsites for potential application as a soil conditioner. Legacy waste was excavated from Mulund dumpsite located in Mumbai, India, and < 4 mm fraction (fine fraction) was collected and tested for essential compost parameters like pH, electrical conductivity, total organic carbon (TOC), primary nutrients, and heavy metals. Further, the impact of fine fraction on plant growth was studied using phytotoxicity and vegetation test. The results show that except for TOC, fine fraction meets most of the physicochemical characteristics standard prescribed for Indian MSW-based compost. The fine fraction had significant nutrient content, i.e., 0.81% (N), 0.27% (P as P2O5), and 0.55% (K as K2O), compared to local soil and meets the Indian MSW-based compost standards, except for phosphorous. However, the total heavy metals in fine fraction exceeded the standard limits for chromium, copper, nickel, lead, and zinc. The germination index of tomato seeds (Lycopersicon esculentum) for the fine fraction extract was more than that of the control for aged fine fraction (> 5 years old), whereas inhibition was observed for fine fraction less than 3 years old. The vegetation test on Napier grass (Pennisetum purpureum) showed that the fine fraction amended soil had a 53-56% increase in biomass yield compared to soil. Based on the characteristics of fine fraction, different potential applications, such as fertilizer, soil enricher, or substrate for remediation activity, are identified; however, caution will be desired on a case-to-case basis.

Functional and Radiological Outcomes of Unstable Proximal Femur Fractures Fixed With Anatomical Proximal Locking Compression Plate.

Introduction Peritrochanteric fractures are the most frequent fractures of the proximal femur that accounts for nearly half of all proximal femur fractures. They are a major cause of disability in the elderly. The aim is to study the functional and radiological outcome of unstable proximal femur fractures fixed with proximal femur locking compression plate (PF-LCP) and its complications. Unstable proximal femur fracture patients operated with proximal femur locking compression plate were followed up functionally by Harris Hip Score and radiologically by neck-shaft angle measure. Materials and methods A retrospective analysis of 30 patients with unstable peritrochanteric fractures treated with PF-LCP in the first-level trauma center was conducted between 2015 and 2019. Stable peritrochanteric, pediatric and open fractures, and polytrauma were excluded. As a mid-term follow-up, functional and radiological outcomes were assessed at six weeks, three months, six months, and 12 months. Data was analyzed using a chi-square test, and results were compared with available western literature.  Results Thirty patients with unstable peritrochanteric fractures operated between 2015 and 2019, complying with our inclusion criteria, were analyzed. All patients were operated by the same surgeon and were available for a mid-term follow-up (12 months). Mean radiological union time was 12.5+/-2 weeks, with 24 patients achieving union between 10-15 weeks, three patients had union little more than 15 weeks. Two patients had non-union and required re-surgery. Functional results were assessed in the 30 patients available for follow-up using Harris Hip Score. Excellent results were seen in 17, good in seven, fair in three, and poor in three patients. Conclusions The choice of implant used to manage unstable peritrochanteric fractures has always been a debatable subject in our orthopedic fraternity. In our study, we used the anatomic, fixed-angle plates in peritrochanteric fractures and obtained significant functional and radiological outcomes over a midterm follow-up. We recommend PF-LCP as a good, stable alternative in the treatment of peritrochanteric femoral fractures. We consider that fracture pattern and extent in the proximal femur have a definite influence in determining the implant of choice. It provides good-to-excellent bone healing with reduced complications and better biomechanical stability.

Trifecta and Pentafecta Outcomes in Laparoscopic and Robotic Nephron-Sparing Surgery for Highly Complex Renal Tumors: A Propensity Score-Matched Cohort Analysis.

Purpose: To compare the trifecta and pentafecta outcomes of laparoscopic partial nephrectomy (LPN) and robotic partial nephrectomy (RPN) in highly complex renal tumors (RENAL nephrometry score ≥10) using a matched cohort analysis. Methods: Patients undergoing LPN or RPN for renal tumors with RENAL score ≥10 between January 2014 and December 2019 were matched using 1:2 propensity score match analysis based on age, body mass index, gender, laterality of tumor, RENAL score, and American Society of Anesthesiologists (ASA) score. The two groups were compared for trifecta and pentafecta outcomes. Results: Thirty patients undergoing LPN (Group A) were matched with 60 patients undergoing RPN (Group B). The mean age (standard deviation) was 53.7 (12.9) years. The median (interquartile range) RENAL score was 10 (10-11). In comparison, the mean warm ischemia time in Group A was significantly longer than that in Group B (26.2 vs 23.0 minutes, p = 0.013). The overall complication rate was 36.7% in Group A as compared with 20% in Group B (p = 0.440). The trifecta outcomes could be achieved in 11 patients (36.7%) in Group A compared with 40 patients (66.7%) in Group B (p = 0.012). Moreover, 10 patients (33.3%) in Group A and 28 patients (46.7%) in Group B achieved pentafecta outcomes (p = 0.227). Conclusions: In a matched cohort of patients undergoing nephron-sparing surgery for highly complex renal tumors (RENAL score ≥10), the robotic approach offers a superior advantage in the achievement of trifecta outcomes as compared with the laparoscopic approach. However, both LPN and RPN can achieve similar pentafecta outcomes.

Mobility and environmental fate of heavy metals in fine fraction of dumped legacy waste: Implications on reclamation and ecological risk.

The study evaluates mobility and chemical speciation of heavy metals (HMs) in fine fraction (<4 mm) collected from municipal solid waste dumpsite located in Mumbai, India to assess its reclamation feasabilty. A total of fifteen samples were collected from five zones (named chronologically, zone A to zone E, with the increasing waste age) at 1-m depth interval to understand temporal variation in mobility and potential pollution risk of heavy metals. The results depicted that Zn had the highest concentration in the fine fraction, followed by Cu > Cr > Pb > Ni > Cd. Furthermore, HMs concentration showed increasing trend with the waste age. According to hiererachial cluster analysis, two cluster were observed in the analyzed samples which could be differentiated with age of the waste. Further, the chemical speciation differed for all assessed HMs and had a significant change with age. HMs were dominant in non-bioavailable forms, except for Cd that had significant distribution in all forms. In addition, Cd (23%) and Zn (17%) showed high mobility amongst all analyzed HM, while Cr (0.4%) had the least. According to pollution assessment and chemical speciation results, Cd was identified as the most polluting and mobile HM. The study shows that the mobile form of HMs is low and needs to be considered while deciding the remediation routes and environment hazards.

Repository Corticotropin in Treating de novo C3 Glomerulonephritis after Transplantation.

Introduction: De novo C3 glomerulonephritis (C3GN) after transplant is uncommon. Although eculizumab has been used successfully in several cases, the response is heterogeneous, and treatment strategies remain undefined. The use of repository corticotropin in C3GN has not been described in the literature. Case Report: A 48-year-old African American male with kidney transplantation secondary to presumed diabetic nephropathy presented 6 years after transplant with lower extremity edema and nephrotic range proteinuria. His urine protein to creatinine ratio (UPCR) was 8.2 g/g. Renal allograft biopsy confirmed the diagnosis of C3GN. He was treated with eculizumab (Solaris®) 900 mg IV once weekly for 4 weeks and repository corticotropin (H.P. Acthar® gel) 80 units SQ twice weekly for 6 months with a near-complete resolution of proteinuria within 3 months of the treatment. The patient presented again 6 months after completing the therapy with a recurrence of proteinuria, which peaked at 11.6 g/g of UPCR. Repeat kidney allograft biopsy was consistent with C3GN. He was started on repository corticotropin 80 units SQ twice weekly, which resulted in a reduction of proteinuria to >50% within 2 months of therapy. When eculizumab 900 mg IV weekly for 4 weeks was added with repository corticotropin, the proteinuria resolved within 10 weeks of treatment. The patient was maintained on monotherapy of repository corticotropin and has been in complete remission of proteinuria for more than a year until his last follow-up. Conclusion: This is the first case report describing the role of repository corticotropin as an effective therapy in reducing proteinuria and maintaining patients with C3GN in proteinuria remission.

EEG Characteristics in COVID-19 Survivors and Non-survivors With Seizures and Encephalopathy.

The objective of this study is to report EEG findings in both COVID-19 survivors and non-survivors who underwent EEG either due to seizure or encephalopathy. Out of total 1468 COVID-19-positive patients, 19 patients underwent EEG. Eight out of 19 patients had a history of seizure disorder and in the remaining 11 with no prior history of seizures, four had a clinical seizure during their hospital stay. Only one had new-onset complex focal status epilepticus on EEG. Amongst the survivors (13/19), the most common EEG findings were normal followed by mild diffuse slowing. Amongst the non-survivors (6/19), the most common EEG finding was moderate to severe slowing in 50% of the patients. It can be deduced that COVID-19 infection does not increase the propensity of epileptiform discharges on EEG. There is perhaps a trend towards increased risk of new-onset status epilepticus in patients with encephalopathy and focal lesions.

The Future of Flash Graphene for the Sustainable Management of Solid Waste.

Graphene research has steadily increased, and its commercialization in many applications is becoming a reality because of its superior physicochemical properties and advances in synthesis techniques. However, bulk-scale production of graphene still requires large amounts of solvents, electrochemical treatment, or sonication. Recently, a method was discovered to convert bulk quantities of carbonaceous materials to graphene using flash Joule heating (FJH) and, so named, flash graphene (FG). This method can be used to turn various solid wastes containing the prerequisite element carbon into FG. Globally, more than 2 billion tons of municipal solid waste (MSW) are generated every year and, in many municipalities, are becoming unmanageable. The most commonly used waste management methods include recycling, composting, anaerobic digestion, incineration, gasification, pyrolysis, and landfill disposal. However, around 70% of global waste ends up in landfills or open dumps, while the rest is recycled, composted, or incinerated. Even the various waste valorization techniques, such as pyrolysis and gasification, produce some waste residues that have their ultimate destination in landfills. Thus, technologies that can minimize waste volume or convert waste into valuable products are required. The thermal treatment process of FJH for FG production provides both waste volume reduction and valorization in the form of FG. In this Perspective, we provide an overview of FJH and its possible applications in various types of waste conversion/valorization. We describe the typical current MSW management system as well as the potential for creating FG at various stages and propose a schematic plan for the incorporation of FG in MSW management. We also analyze the strengths, weaknesses, opportunities, and threats of MSW as an FG precursor in terms of technical, economic, environmental, and social sustainability. This valuable waste valorization and management strategy can help achieve near-zero waste and an economy-boosting MSW management system.

Impact of Acute Confusional State in Patients With COVID-19 and a Predictive Score.

BACKGROUND: Acute confusional state (ACS) in COVID-19 is shown to be associated with poor clinical outcomes. METHODS: We assessed the impact of ACS - defined as a documented deterioration of mental status from baseline on the alertness and orientation to time, place, and person - on inpatient mortality and the need for intensive care unit (ICU) transfer in inpatient admissions with active COVID-19 infection in a single-center retrospective cohort of inpatient admissions from a designated COVID-19 tertiary care center using an electronic health record system. Furthermore, we developed and validated a neurological history and symptom-based predictive score of developing ACS. RESULTS: Thirty seven out of 245 (15%) patients demonstrated ACS. Nineteen (51%) patients had multifactorial ACS, followed by 11 (30%) patients because of hypoxemia. ACS patients were significantly older (80 [70-85] years vs 50.5 [38-69] years, p < 0.001) and demonstrated more frequent history of dementia (43% vs 9%, p < 0.001) and epilepsy (16% vs 2%, p = 0.001). ACS patients observed significantly higher in-hospital mortality (45.9% vs 1.9%, aOR [adjusted odds ratio]: 15.7, 95% CI = 3.6-68.0, p < 0.001) and need for ICU transfer (64.9% vs 35.1%, aOR: 2.7, 95% CI = 1.2-6.1, p = 0.015). In patients who survived hospitalization, ACS was associated with longer hospital stay (6 [3.5-10.5] days vs 3 [2-7] day, p = 0.012) and numerically longer ICU stay (6 [4-10] days vs 3 [2-6] days, p = 0.078). A score to predict ACS demonstrated 75.68% sensitivity and 81.73% specificity at a cutoff of ≥3. CONCLUSION: A high prevalence of ACS was found in patients with COVID-19 in our study cohort. Patients with ACS demonstrated increased mortality and need for ICU care. An internally validated score to predict ACS demonstrated high sensitivity and specificity in our cohort.

Comparison of Canal Transportation in TruNatomy, ProTaper Gold, and Hyflex Electric Discharge Machining File Using Cone-beam Computed Tomography.

AIM: This study was carried out to compare canal transportation in three new rotary file systems, namely TruNatomy, ProTaper Gold, and Hyflex Electric Discharge Machining file system, using cone-beam computed tomography. MATERIALS AND METHODS: The study was conducted on 105 extracted teeth consisting of 60 extracted mandibular first molars and 45 mandibular second premolars involving the mesiolingual canal of mandibular first molar and the root canal of second premolar. The teeth were randomly divided into three groups of 35 out of which each group consisted of 20 mandibular first molars and 15 mandibular second premolars. The TruNatomy rotary file was used in group I, ProTaper Gold was used in group II, and Hyflex Electric Discharge Machining was used in group III. Cone-beam computed tomography scan images were obtained both before and after instrumentation. Changes caused by preparation in the coronal, middle, and apical thirds were determined on cone-beam computed tomography scans and analyzed using the Kruskal-Wallis test at p ≤ 0.05 level of significance. RESULTS: TruNatomy showed least amount of canal transportation as compared with other two file systems at all the three levels of canals. ProTaper Gold showed maximum amount of canal transportation as compared with other two file systems at all the three levels of canals. The Hyflex EDM rotary file system showed transportation, which was more than the TruNatomy file system while it was less than that of ProTaper Gold. The difference was statically significant at the middle one-third level (p = 0.03) and at the coronal level (p = 0.02). CONCLUSION: The TruNatomy system has least amount of canal transportation as compared with ProTaper Gold and Hyflex EDM system. With potential to preserve tooth structure, this file has an added advantage over other rotary file systems. CLINICAL SIGNIFICANCE: The TruNatomy file system has been recently introduced with good cyclic fatigue resistance. It is necessary to evaluate the root canal transportation caused by the TruNatomy file.

Using handpicked features in conjunction with ResNet-50 for improved detection of COVID-19 from chest X-ray images.

Coronaviruses are a family of viruses that majorly cause respiratory disorders in humans. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of coronavirus that causes the coronavirus disease 2019 (COVID-19). WHO has identified COVID-19 as a pandemic as it has spread across the globe due to its highly contagious nature. For early diagnosis of COVID-19, the reverse transcription-polymerase chain reaction (RT-PCR) test is commonly done. However, it suffers from a high false-negative rate of up to 67% if the test is done during the first five days of exposure. As an alternative, research on the efficacy of deep learning techniques employed in the identification of COVID-19 disease using chest X-ray images is intensely pursued. As pneumonia and COVID-19 exhibit similar/ overlapping symptoms and affect the human lungs, a distinction between the chest X-ray images of pneumonia patients and COVID-19 patients becomes challenging. In this work, we have modeled the COVID-19 classification problem as a multiclass classification problem involving three classes, namely COVID-19, pneumonia, and normal. We have proposed a novel classification framework which combines a set of handpicked features with those obtained from a deep convolutional neural network. The proposed framework comprises of three modules. In the first module, we exploit the strength of transfer learning using ResNet-50 for training the network on a set of preprocessed images and obtain a vector of 2048 features. In the second module, we construct a pool of frequency and texture based 252 handpicked features that are further reduced to a set of 64 features using PCA. Subsequently, these are passed to a feed forward neural network to obtain a set of 16 features. The third module concatenates the features obtained from first and second modules, and passes them to a dense layer followed by the softmax layer to yield the desired classification model. We have used chest X-ray images of COVID-19 patients from four independent publicly available repositories, in addition to images from the Mendeley and Kaggle Chest X-Ray Datasets for pneumonia and normal cases. To establish the efficacy of the proposed model, 10-fold cross-validation is carried out. The model generated an overall classification accuracy of 0.974 ± 0.02 and a sensitivity of 0.987 ± 0.05, 0.963 ± 0.05, and 0.973 ± 0.04 at 95% confidence interval for COVID-19, normal, and pneumonia classes, respectively. To ensure the effectiveness of the proposed model, it was validated using an independent Chest X-ray cohort and an overall classification accuracy of 0.979 was achieved. Comparison of the proposed framework with state-of-the-art methods reveal that the proposed framework outperforms others in terms of accuracy and sensitivity. Since interpretability of results is crucial in the medical domain, the gradient-based localizations are captured using Gradient-weighted Class Activation Mapping (Grad-CAM). In summary, the results obtained are stable over independent cohorts and interpretable using Grad-CAM localizations that serve as clinical evidence.

Physicochemical and FTIR spectroscopic analysis of fine fraction from a municipal solid waste dumpsite for potential reclamation of materials.

Improper municipal solid waste management in the past has landed most of this waste in open dumps of India. This dumped waste has a negative effect on the environment and human health and needs to be reclaimed either for material/energy recovery or to create space for future waste management. Since nearly half of the waste in dumpsites can be classified as fine fraction, in-depth knowledge of its characteristics is required to reclaim these dumpsites successfully. In this study, we characterize fine fraction, <4 mm, aged 1-10 years old, obtained from Mulund dumpsite in Mumbai, using physicochemical and spectroscopic analysis. The study also highlights different valorization routes to reclaim the fine fraction. The fine fraction was ~45% in the dumpsite and increased with the age of the waste. Visual inspection revealed that fine fraction older than five years was relatively homogeneous compared with younger fine fraction. Furthermore, pH (7.4-7.8) and electrical conductivity (0.70-1.92 mS cm-1) of the fine fraction met the Indian MSW compost standards; however, heavy metal levels were higher than the proposed standards. The fine fraction also had a high concentration of metals like aluminium (11 g kg-1) and iron (78 g kg-1), indicating metal recovery potential. Furthermore, Fourier Transform Infrared Spectroscopy results show that the fine fraction had dominant inorganic peaks and became relatively homogeneous with age. The study proposes fine fraction use as a secondary resource; however, some prior treatment would be required based on the application.