Hydrochemical and isotopic characteristics on the southern and northern slopes of the Himalayas: spatio-temporal controls and source apportionment.

Water-soluble ions, inorganic nitrogen, and stable isotopes in precipitation were assessed from the southern (Koshi Tappu and Khandbari) and northern slopes (Lhasa and SET) of the Himalayas to understand the sources, chemistry of regional precipitation, and climatic processes. Water soluble ions showed distinct seasonal variation, with higher concentrations in the non-monsoon. The concentration of ionic species was highest in Koshi Tappu, followed by Lhasa, SET, and Khandbari. The sources were from the terrigenous (Ca2+, HCO3-), marine (Na+ and Cl-), anthropogenic (SO42-, NO3-, and NH4+), terrigenous and marine (Mg2+), and biomass-burning (K+). The southern slope, relative to the northern, was more prone to anthropogenic emissions with higher deposition. Among all sites, inorganic nitrogen deposition at Koshi Tappu was higher than the threshold value (10 kg ha-1 y-1). The isotopic composition during the study period was higher in non-monsoon, started declining from June, and depleted in July and August compared to other months, i.e., the monsoon mature phase, along the south-to-north transect. The diminished value of stable isotopes in precipitation with increasing altitude underlines the evidence of the orographic effect in isotopic composition. Our study delineated that the higher/lower d-excess value increased with altitude on the southern/northern slope of the Himalayas. The backward trajectory analysis and the National Centers for Environmental Prediction's Final (NCEP FNL) datasets identified that most of the trajectories arrived from warm and humid low-latitude regions during monsoon and westerlies in non-monsoon. Thus, the chemical characteristics and stable isotopic composition of precipitation differed on the southern and northern slopes of the Himalayas by orographic effect and various sources. This study provides new insights into the atmospheric environment and climatic control of stable isotopes in the Himalayan Tibetan Plateau and facilitates monitoring of transboundary air pollution.

Screening of Peripheral Arterial Disease in Patients with Diabetes.

BACKGROUND: Out of many atherosclerotic complications, peripheral arterial disease (PAD) is also important one. To prevent morbidity and mortality related with PAD, early detection is must, and is possible by duplex screening. This study aims at screening for PAD in patients with type 2 Diabetes mellitus. METHODS: This study is single centered cross- sectional, observational study conducted in department of internal medicine of DMCRI- a tertiary care hospital. A total of 140, type 2 diabetes patients were screened for peripheral arterial disease by duplex ultrasound after taking informed consent and fulfilling inclusion and exclusion criteria. RESULTS: In our study among 140 Participants, 50% are male and 50% are female with mean age of 57.6 ± 10.4 years standard deviation (SD) and mean duration of diabetes was 8.31± 5.9 SD years with 13.6% were alcohol consumer; 1.4% were smokers; 59.3% of them had high blood pressure; (28.6%) had dyslipidaemia and 11.4% had hypothyroidism. The prevalence of PAD in type 2 diabetes was 27.1% in our study. The mean of glycated hemoglobin (HBA1c) was 7.23 ± 1.75% and while performing analytical test {chi-square (χ)}, we found there was no association between HBA1c level and presence of peripheral arterial disease. CONCLUSIONS: The prevalence of peripheral arterial disease is high almost more than one quarter (27.1%). Screening of diabetic patients is must especially those aged and high glycated hemoglobin for early detection and effective management of PAD.

Into Thick(er) Air? Oxygen Availability at Humans' Physiological Frontier on Mount Everest.

Global audiences are captivated by climbers pushing themselves to the limits in the hypoxic environment of Mount Everest. However, air pressure sets oxygen abundance, meaning it varies with the weather and climate warming. This presents safety issues for mountaineers but also an opportunity for public engagement around climate change. Here we blend new observations from Everest with ERA5 reanalysis (1979-2019) and climate model results to address both perspectives. We find that plausible warming could generate subtle but physiologically relevant changes in summit oxygen availability, including an almost 5% increase in annual minimum VO2 max for 2°C warming since pre-industrial. In the current climate we find evidence of swings in pressure sufficient to change Everest's apparent elevation by almost 750 m. Winter pressures can also plunge lower than previously reported, highlighting the importance of air pressure forecasts for the safety of those trying to push the physiological frontier on Mt. Everest.