Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit.

End-of-life care (EOLC) exemplifies the joint mission of intensive and palliative care (PC) in their human-centeredness. The explosion of technological advances in medicine must be balanced with the culture of holistic care. Inevitably, it brings together the science and the art of medicine in their full expression. High-quality EOLC in the ICU is grounded in evidence, ethical principles, and professionalism within the framework of the Law. Expert professional statements over the last two decades in India were developed while the law was evolving. Recent landmark Supreme Court judgments have necessitated a review of the clinical pathway for EOLC outlined in the previous statements. Much empirical and interventional evidence has accumulated since the position statement in 2014. This iteration of the joint Indian Society of Critical Care Medicine-Indian Association of Palliative Care (ISCCM-IAPC) Position Statement for EOLC combines contemporary evidence, ethics, and law for decision support by the bedside in Indian ICUs. How to cite this article: Mani RK, Bhatnagar S, Butola S, Gursahani R, Mehta D, Simha S, et al. Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit. Indian J Crit Care Med 2024;28(3):200-250.

Optically-Trapped Nanodiamond-Relaxometry Detection of Nanomolar Paramagnetic Spins in Aqueous Environments.

Probing electrical and magnetic properties in aqueous environments remains a frontier challenge in nanoscale sensing. Our inability to do so with quantitative accuracy imposes severe limitations, for example, on our understanding of the ionic environments in a diverse array of systems, ranging from novel materials to the living cell. The Nitrogen-Vacancy (NV) center in fluorescent nanodiamonds (FNDs) has emerged as a good candidate to sense temperature, pH, and the concentration of paramagnetic species at the nanoscale, but comes with several hurdles such as particle-to-particle variation which render calibrated measurements difficult, and the challenge to tightly confine and precisely position sensors in aqueous environment. To address this, we demonstrate relaxometry with NV centers within optically-trapped FNDs. In a proof of principle experiment, we show that optically-trapped FNDs enable highly reproducible nanomolar sensitivity to the paramagnetic ion, (\mathrm{Gd}^{3+}). We capture the three distinct phases of our experimental data by devising a model analogous to nanoscale Langmuir adsorption combined with spin coherence dynamics. Our work provides a basis for routes to sense free paramagnetic ions and molecules in biologically relevant conditions.

Modeling fine-grained spatio-temporal pollution maps with low-cost sensors.

The use of air quality monitoring networks to inform urban policies is critical especially where urban populations are exposed to unprecedented levels of air pollution. High costs, however, limit city governments' ability to deploy reference grade air quality monitors at scale; for instance, only 33 reference grade monitors are available for the entire territory of Delhi, India, spanning 1500 sq km with 15 million residents. In this paper, we describe a high-precision spatio-temporal prediction model that can be used to derive fine-grained pollution maps. We utilize two years of data from a low-cost monitoring network of 28 custom-designed low-cost portable air quality sensors covering a dense region of Delhi. The model uses a combination of message-passing recurrent neural networks combined with conventional spatio-temporal geostatistics models to achieve high predictive accuracy in the face of high data variability and intermittent data availability from low-cost sensors (due to sensor faults, network, and power issues). Using data from reference grade monitors for validation, our spatio-temporal pollution model can make predictions within 1-hour time-windows at 9.4, 10.5, and 9.6% Mean Absolute Percentage Error (MAPE) over our low-cost monitors, reference grade monitors, and the combined monitoring network respectively. These accurate fine-grained pollution sensing maps provide a way forward to build citizen-driven low-cost monitoring systems that detect hazardous urban air quality at fine-grained granularities.