A simple three-cylinder radiometer and low-speed anemometer to characterize human extreme heat exposure.

As populations and temperatures of urban areas swell, more people face extreme heat and are at increasing risk of adverse health outcomes. Radiation accounts for much of human heat exposure but is rarely used as heat metric due to a lack of cost-effective and accurate sensors. To this end, we fuse the concepts of a three-globe radiometer-anemometer with a cylindrical human body shape representation, which is more realistic than a spherical representation. Using cost-effective and readily available materials, we fabricated two combinations of three cylinders with varying surface properties. These simple devices measure the convection coefficient and the shortwave and longwave radiative fluxes. We tested the devices in a wind tunnel and at fourteen outdoor sites during July 2023's record-setting heat wave in Tempe, Arizona. The average difference between pedestrian-level mean radiant temperature (MRT) measured using research-grade 3-way net radiometers and the three-cylinder setup was 0.4 ± 3.0 °C ( ±  1 SD). At most, we observed a 10 °C MRT difference on a white roof site with extreme MRT values (70 °C to 80 °C), which will be addressed through discussed design changes to the system. The measured heat transfer coefficient can be used to calculate wind speed below 2 m·s-1; thus, the three cylinders combined also serve as a low-speed anemometer. The novel setup could be used in affordable biometeorological stations and deployed across urban landscapes to build human-relevant heat sensing networks.

Comparison of two different doses of hyperbaric bupivacaine for intracavitary radiotherapy in patients with carcinoma cervix - A randomized control trial.

Background: Subarachnoid block has been used for intracavitary radiotherapy (ICRT) for carcinoma cervix, but the literature on the appropriate dose of local anesthetic required to achieve the desired effect is lacking. We compared two different intrathecal doses of 0.5% hyperbaric bupivacaine (1.2 and 1.5 mL) for providing optimal surgical conditions and readiness to discharge in patients undergoing ICRT for carcinoma cervix. Materials and Methods: This prospective double-blind study was done in 80 patients undergoing ICRT. The patients were randomized into two groups (Groups I and II) to receive 1.2 and 1.5 mL of intrathecal hyperbaric bupivacaine, respectively, for ICRT. The level of sensory achieved, the patient satisfaction score, radiation oncologist score, time to L5 regression, and time to motor recovery (walking unaided) were assessed. Statistical Analysis Used: The data were analyzed using SPSS 20 for Windows (IBM, Chicago, IL, USA). Results: The time taken for the block to regress to L5 (Group I: 134.6 ± 32.4 minutes vs. Group II: 143.2 ± 43.0 minutes, P = 0.31) were comparable. However, the mean time for walking unaided (Group I: 220.87 ± 47.12 minutes versus Group II: 247.00 ± 49.83 minutes, P = 0.032) after the subarachnoid block was significantly less in Group I. The patient satisfaction with the procedure and overall satisfaction of the radiation oncologists regarding the operating condition were comparable in both the groups. Conclusions: Hence, a 1.2 mL dose of intrathecal hyperbaric bupivacaine for ICRT provides optimal surgical conditions with hemodynamic stability and ensures the early discharge of the patient.

Qualitative and quantitative assessment of diatom deformities and protoplasmic condition under metal and metalloid stress.

Metals and metalloids are toxic, persistent, and non-biodegradable and can be biomagnified (e.g., Hg), and therefore pose a serious threat to the algal flora of aquatic ecosystems. This laboratory study tested the effects of metals (Zn, Fe, and Hg) and a metalloid (As) on the cell wall morphology and protoplasmic content of living cells of six widespread diatom genera over 28 days. Diatoms exposed to Zn and Fe had a higher frequency of deformed diatom frustules (> 1%) compared to the As, Hg, and control treatments (< 1%). Deformities in the valve outline and striae were found in all treatments, including the control, whereas deformed raphes and more than one type of deformity were more prevalent under Zn and Hg stress. The order of toxicity is as follows: Zn > Fe > Hg≈As. Deformities were more frequent in Achnanthes and Diploneis (adnate forms) than in the motile genera of Nitzschia and Navicula. The correlation between the % healthy diatoms and % deformities in all six genera showed a negative relationship with the integrity of protoplasmic content (i.e., greater alteration in protoplasmic content was associated with greater frustule deformation). We conclude that diatom deformities can be a good indicator of metal and metalloid stress in waterbodies and are very useful in the rapid biomonitoring of aquatic ecosystems.

Visible-Light-Induced Oxidative α-keto-Dichlorination of Arylalkynes by CuCl2 at Room Temperature.

A visible light-induced oxidative α-keto-dichlorination of terminal and internal aryl alkynes was developed to form dichloroacetophenones (DCAPs) and dichlorophenyl-acetophenones (DCPAPs), respectively, by using CuCl2 as a photoredox catalyst in the presence of air at room temperature (without using any exogenous photocatalyst). Here, photoexcited CuCl2 underwent ligand-to-metal charge transfer to generate a Cl radical, which readily added to the alkynes to form DCAPs or DCPAPs in the presence of O2 . This α-keto-dichlorination reaction is a green and mild protocol as it produced water as the only by-product. Moreover, the evaluation of green chemistry metrics indicated that the E-factor (mass of wastes/mass of products) of the current α-keto-chlorination method is around 10.1 times lower than that of a literature-reported photochemical method. The Eco Scale value (score 55, which on a scale of 0-100 indicates an acceptable synthesis) signifies that this process is simple, highly efficient, eco-friendly, and cost-effective.

Cotard's syndrome in the postoperative period following head and neck cancer surgery - A case report.

Major head and neck surgery is a known factor for postoperative delirium; however, Cotard's syndrome (CS) has been rarely reported following head and neck surgery. We report a case of a 51-year-old man who underwent surgery for carcinoma right buccal mucosa and developed agitation and nihilistic delusion after extubation. The patient had a preexisting psychiatric history which is often reported as a risk factor for CS. Of interest, though is that this condition subsided as quickly as it emerged with only supportive counselling and brief pharmacotherapy.

Medicolite-Machine Learning-Based Patient Care Model.

This paper discusses the machine learning effect on healthcare and the development of an application named "Medicolite" in which various modules have been developed for convenience with health-related problems like issues with diet. It also provides online doctor appointments from home and medication through the phone. A healthcare system is "Smart" when it can decide on its own and can prescribe patients life-saving drugs. Machine learning helps in capturing data that are large and contain sensitive information about the patients, so data security is one of the important aspects of this system. It is a health system that uses trending technologies and mobile internet to connect people and healthcare institutions to make them aware of their health condition by intelligently responding to their questions. It perceives information through machine learning and processes this information using cloud computing. With the new technologies, the system decreases the manual intervention in healthcare. Every single piece of information has been saved in the system and the user can access it any time. Furthermore, users can take appointments at any time without standing in a queue. In this paper, the authors proposed a CNN-based classifier. This CNN-based classifier is faster than SVM-based classifier. When these two classifiers are compared based on training and testing sessions, it has been found that the CNN has taken less time (30 seconds) compared to SVM (58 seconds).

Role of Biomaterials in Cardiac Repair and Regeneration: Therapeutic Intervention for Myocardial Infarction.

Heart failure or myocardial infarction (MI) is one of the world's leading causes of death. Post MI, the heart can develop pathological conditions such as ischemia, inflammation, fibrosis, and left ventricular dysfunction. However, current surgical approaches are sufficient for enhancing myocardial perfusion but are unable to reverse the pathological changes. Tissue engineering and regenerative medicine approaches have shown promising effects in the repair and replacement of injured cardiomyocytes. Additionally, biomaterial scaffolds with or without stem cells are established to provide an effective environment for cardiac regeneration. Excipients loaded with growth factors, cytokines, oligonucleotides, and exosomes are found to help in such cardiac eventualities by promoting angiogenesis, cardiomyocyte proliferation, and reducing fibrosis, inflammation, and apoptosis. Injectable hydrogels, nanocarriers, cardiac patches, and vascular grafts are some excipients that can help the self-renewal in the damaged heart but are not understood well yet, in the context of used biomaterials. This review focuses on the use of various biomaterial-based approaches for the regeneration and repair of cardiac tissue postoccurrence of MI. It also discusses the outlines of cardiac remodeling and current therapeutic approaches after myocardial infarction, which are translationally important with respect to used biomaterials. It provides comprehensive details of the biomaterial-based regenerative approaches, which are currently the focus of the research for cardiac repair and regeneration and can provide a broad outline for further improvements.

Multifunctional graphene oxide nanoparticles for drug delivery in cancer.

Recent advancements in nanotechnology have enabled us to develop sophisticated multifunctional nanoparticles or nanosystems for targeted diagnosis and treatment of several illnesses, including cancers. To effectively treat any solid tumor, the therapy should preferably target just the malignant cells/tissue with minor damage to normal cells/tissues. Graphene oxide (GO) nanoparticles have gained considerable interest owing to their two-dimensional planar structure, chemical/mechanical stability, excellent photosensitivity, superb conductivity, high surface area, and good biocompatibility in cancer therapy. Many compounds have been functionalized on the surface of GO to increase their biological applications and minimize cytotoxicity. The review presents an overview of the physicochemical characteristics, strategies for various modifications, toxicity and biocompatibility of graphene and graphene oxide, current trends in developing GO-based nano constructs as a drug delivery cargo and other biological applications, including chemo-photothermal therapy, chemo-photodynamic therapy, bioimaging, and theragnosis in cancer. Further, the review discusses the challenges and opportunities of GO, GO-based nanomaterials for the said applications. Overall, the review focuses on the therapeutic potential of strategically developed GO nanomedicines and comprehensively discusses their opportunities and challenges in cancer therapy.

Multi-echelon agri-food supply chain network design integrating operational and strategic objectives: a case of public distribution system in India.

The global concern to ensure the availability of food for the growing world's population draws urgent attention towards the inefficiencies in agri-food supply chains. Agri-food supply chains are inherently complex to manage than other supply chains mainly because of their multi-echelon structure, deteriorating product quality with time and changes in storage conditions which leads to significant amount of food loss and wastage. Additionally, any natural or man-made disaster further disrupts the chain and leads to high food loss, high supply chain costs, reduced food availability and poor food quality. Hence, there is a need to design resilient and efficient agri-food supply chain network for optimal multi-echelon storage and distribution to reduce food loss and quality degradation. For this purpose, a Fuzzy Multi Objective Linear Program (FMOLP) is proposed in this paper for integrated food procurement, storage and distribution under cost, resilience and quality considerations. The proposed model integrates the short-term operational objective of cost optimization with the long-term sustainable objectives of food loss minimization and resilience maximization. The proposed FMOLP is illustrated using a realistic case of Public Distribution System using the data benchmarked with the numbers reported by the Food corporation of India. The detailed computational analysis carried out in the paper in investigates three categories of problem sizes to compare and contrast the decisions using different strategies and to provide organizational, operational and policy insights on the trade-off between cost, food loss and resilience.

Machine Learning and IoT-Based Waste Management Model.

A rapid rise in inhabitants across the globe has led to the inadmissible management of waste in various countries, giving rise to various health issues and environmental pollution. The waste-collecting trucks collect waste just once or twice in seven days. Due to improper waste collection practices, the waste in the dustbin is spread on the streets. Thus, to defeat this situation, an efficient solution for smart and effective waste management using machine learning (ML) and the Internet of Things (IoT) is proposed in this paper. In the proposed solution, the authors have used an Arduino UNO microcontroller, ultrasonic sensor, and moisture sensor. Using image processing, one can measure the waste index of a particular dumping ground. A hardware prototype is also developed for the proposed framework. Thus, the presented solution for the efficient management of waste accomplishes the aim of establishing clean and pollution-free cities.

'Our village is dependent on us. That's why we can't leave our work'. Characterizing mechanisms of motivation to perform among Accredited Social Health Activists (ASHA) in Bihar.

Community health workers (CHWs) play major roles in delivering primary healthcare services, linking communities to the formal health system and addressing the social determinants of health. Available evidence suggests that the performance of CHW programmes in low- and middle-income countries can be influenced by context-dependent causal mechanisms such as motivation to perform. There are gaps regarding what these mechanisms are, and what their contribution is to CHW performance. We used a theory-driven case study to characterize motivational mechanisms among Accredited Social Health Activists (ASHAs) in Bihar, India. Data were collected through semi-structured interviews with CHWs and focus group discussions with beneficiary women. Data were coded using a combined deductive and inductive approach. We found that ASHAs were motivated by a sense of autonomy and self-empowerment; a sense of competence, connection and community service; satisfaction of basic financial needs; social recognition; and feedback and answerability. Findings highlight the potential of ASHAs' intrinsic motivation to increase their commitment to communities and identification with the health system and of programme implementation and management challenges as sources of work dissatisfaction. Efforts to nurture and sustain ASHAs' intrinsic motivation while addressing these challenges are necessary for improving the performance of Bihar's ASHA programme. Further research is needed to characterize the dynamic interactions between ASHAs' motivation, commitment, job satisfaction and overall performance; also, to understand how work motivation is sustained or lost through time. This can inform policy and managerial reforms to improve ASHA programme's performance.

OT-82, a novel anticancer drug candidate that targets the strong dependence of hematological malignancies on NAD biosynthesis.

Effective treatment of some types of cancer can be achieved by modulating cell lineage-specific rather than tumor-specific targets. We conducted a systematic search for novel agents selectively toxic to cells of hematopoietic origin. Chemical library screenings followed by hit-to-lead optimization identified OT-82, a small molecule with strong efficacy against hematopoietic malignancies including acute myeloblastic and lymphoblastic adult and pediatric leukemias, erythroleukemia, multiple myeloma, and Burkitt's lymphoma in vitro and in mouse xenograft models. OT-82 was also more toxic towards patients-derived leukemic cells versus healthy bone marrow-derived hematopoietic precursors. OT-82 was shown to induce cell death by inhibiting nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in the salvage pathway of NAD synthesis. In mice, optimization of OT-82 dosing and dietary niacin further expanded the compound's therapeutic index. In toxicological studies conducted in mice and nonhuman primates, OT-82 showed no cardiac, neurological or retinal toxicities observed with other NAMPT inhibitors and had no effect on mouse aging or longevity. Hematopoietic and lymphoid organs were identified as the primary targets for dose limiting toxicity of OT-82 in both species. These results reveal strong dependence of neoplastic cells of hematopoietic origin on NAMPT and introduce OT-82 as a promising candidate for the treatment of hematological malignancies.

Effective targeting of NAMPT in patient-derived xenograft models of high-risk pediatric acute lymphoblastic leukemia.

The prognosis for children diagnosed with high-risk acute lymphoblastic leukemia (ALL) remains suboptimal, and more potent and less toxic treatments are urgently needed. We investigated the efficacy of a novel nicotinamide phosphoribosyltransferase inhibitor, OT-82, against a panel of patient-derived xenografts (PDXs) established from high-risk and poor outcome pediatric ALL cases. OT-82 was well-tolerated and demonstrated impressive single agent in vivo efficacy, achieving significant leukemia growth delay in 95% (20/21) and disease regression in 86% (18/21) of PDXs. In addition, OT-82 enhanced the efficacy of the established drugs cytarabine and dasatinib and, as a single agent, showed similar efficacy as an induction-type regimen combining three drugs used to treat pediatric ALL. OT-82 exerted its antileukemic action by depleting NAD+ and ATP, inhibiting the NAD+-requiring DNA damage repair enzyme PARP-1, increasing mitochondrial ROS levels and inducing DNA damage, culminating in apoptosis induction. OT-82 sensitivity was associated with the occurrence of mutations in major DNA damage response genes, while OT-82 resistance was characterized by high expression levels of CD38. In conclusion, our study provides evidence that OT-82, as a single agent, and in combination with established drugs, is a promising new therapeutic strategy for a broad spectrum of high-risk pediatric ALL for which improved therapies are urgently needed.

Murine mesenchymal cells that express elevated levels of the CDK inhibitor p16(Ink4a) in vivo are not necessarily senescent.

Age-related health decline has been attributed to the accumulation of senescent cells recognized in vivo by p16(Ink4a) expression. The pharmacological elimination of p16(Ink4a)-positive cells from the tissues of mice was shown to extend a healthy lifespan. Here, we describe a population of mesenchymal cells isolated from mice that are highly p16(INK4a)-positive are proficient in proliferation but lack other properties of cellular senescence. These data, along with earlier reports on p16(Ink4a)-positive macrophages, indicate that p16(Ink4a)-positive and senescent cell populations only partially intersect, therefore, extending the list of potential cellular targets for anti- aging therapies.

Comparison of intrathecal dexmedetomidine with buprenorphine as adjuvant to bupivacaine in spinal asnaesthesia.

BACKGROUND: The supplementation of local anaesthetics with adjuvants to improve the efficacy of subarachnoid block has been recognised since long. The most preferred drug has been opioids, but newer drugs like dexmedetomidine has also been introduced and investigated as an effective adjuvant. AIM: This study was conducted to evaluate and compare the characteristics of subarachnoid blockade, hemodynamic stability and adverse effects of intrathecal buprenorphine and intrathecal dexmedetomidine as an adjuvant to 0.5% hyperbaric bupivacaine for lower abdominal surgeries. MATERIALS AND METHODS: The present study included 60 patients aged between 18-60 years classified as American Society of Anesthesiologists (ASA) Physical Status (PS) I/II scheduled for elective lower abdominal surgeries. The patients were randomly allotted to two groups to receive intrathecal 3ml of 0.5% bupivacine with 60µg of buprenorphine (Group B; n=30) or 3ml of 0.5% bupivacaine with 5µg of dexmedetomidine (Group D; n=30). The onset time to peak sensory level, motor block, sedation, Haemodynamic variables, duration of motor block, analgesia and any adverse effects were noted. RESULTS: There was no significant difference between groups regarding demographic characteristics and type of surgery. The motor, sensory blockade and time of rescue analgesia were significantly prolonged in Group D compared to Group B. The sedation level was higher in Group D compared to Group B. There was no significant difference in haemodynamic variables although Group B had lower Heart Rate (HR) than Group D. CONCLUSION: Intrathecal dexmedetomidine when compared to intrathecal buprenorphine causes prolonged anaesthesia and analgesia with reduced need for sedation and rescue analgesics.