A comparative study on the treatment of kitchen grey water using microalgae consortia and microalgae-synthesized silver nanoparticles.

Comparative study on the potential of microalgae consortia and green-synthesized silver nanoparticles using microalgae (M-AgNP) consortia for the treatment of kitchen grey water was investigated in this study. The microalgae consortia consisting of four species, viz., Chlorella sp., Scenedesmus sp., Coelastrum sp., and Pediastrum sp. were isolated from a local fish pond and the silver nanoparticles were synthesized with the same. Thus, synthesized silver nanoparticles exhibited a distinctive yellowish-brown colour and spherical morphology. Extensive qualitative and quantitative characterization techniques were employed to determine their size and morphology. Both microalgae consortia and M-AgNP were used separately for the treatment of kitchen grey water under experimental conditions. The synthesized silver nanoparticles demonstrated promising potential for domestic wastewater treatment, leading to substantial reductions in various parameters: total dissolved solids (29.6%), conductivity (49.4%), chemical oxygen demand (64.6%), and heavy metals (arsenic-63.5%, zinc-45.6%, cadmium-88%, copper-60.52%, and lead-80.82%). Notably, microalgae exhibited superior removal efficiency for nitrate (83.1%), sulphate (70.3%), and phosphate (96.5%) compared to microalgae-synthesized silver nanoparticles. This study underscores the effective utilization of both microalgae and microalgae-synthesized silver nanoparticles for wastewater treatment applications.

Theoretical Study on Tuning Band Gap and Electronic Properties of Atomically Thin Nanostructured MoS2/Metal Cluster Heterostructures.

Nano-heterostructures have attracted immense attention recently due to their remarkable interfacial properties determined by the heterointerface of different nanostructures. Here, using first-principles density functional theory (DFT) calculations, we examine what range the variable electronic properties such as the electronic band gap can be tuned by combining two dissimilar nanostructures consisting of atomically thin nanostructured MoS2 clusters with small silver and gold nanoparticles (Ag/Au NPs). Most interestingly, our calculations show that the electronic band gap of the nanostructured MoS2 cluster can be tuned from 2.48 to 1.58 and 1.61 eV, by the formation of heterostructures with silver and gold metal nanoclusters, respectively. This band gap is ideal for various applications ranging from flexible nanoelectronics to nanophotonics applications. Furthermore, the adsorption of H2 molecules on both nano-heterostructures is investigated, and the computed binding energies are found to be within the desirable range. The reported theoretical results provide inspiration for engineering various optoelectronic applications for nanostructured MoS2-based heterostructures.

Magnetic performance and defect characterization studies of core-shell architectured MgFe2O4@BaTiO3 multiferroic nanostructures.

Multiferroics that permit manipulation of the magnetization vector exclusively by electric fields have spawned extensive interest for memory and logic device applications. In line with this understanding, we herein report the encapsulation of non-ferroelectric magnesium ferrite (MgFe2O4) nanoparticles in a ferroelectric shell of BaTiO3 to produce a system with engineered dielectric, magnetic, magneto-electric and ferroelectric properties. The interface effect on the strain transfer was observed to strongly influence the magneto-electric coupling and the electric and magnetic properties of the system. The model polyhedral image of MgFe2O4@BaTiO3 has helped to get an insight into the core-shell structure. The multiferroicity induced by the excellent coupling between the ferroelectric and magnetostrictive phases at the core-shell interface unlocks wide prospects for device downscaling and information storage applications. The influence of magnetostrictive stress on the magneto-electric coupling effects and domain dynamics was further studied using transmission electron microscopy (TEM) and atomic force microscopy images. Interestingly, the realization of a superparamagnetic multiferroic system has been a breakthrough and facilitates ultra high density magnetic data storage technologies. Evidence for spontaneous polarization and the ferroelectric trait exhibited by the multiferroic samples was revealed from the P-E hysteresis loop. The investigation of defect evolution in the system was carried out using positron annihilation lifetime spectroscopy (PALS) and coincidence Doppler broadening spectroscopy (CDBS) of annihilation radiation and the studies revealed thermal diffusion of positrons into the interfacial regions within the core-shell structure and the "formation and pick-off annihilation of orthopositronium atoms". It is concluded that interface engineering is a strong means for manipulation of the magnetic, dielectric and magneto-electric properties in multiferroic heterostructures for high density electrical energy and magnetic data storage.

Value of Global Surgical Activities for US Academic Health Centers: A Position Paper by the Association for Academic Surgery Global Affairs Committee, Society of University Surgeons Committee on Global Academic Surgery, and American College of Surgeons' Operation Giving Back.

BACKGROUND: Academic global surgery value to low- and middle-income countries (LMICs) is increasingly understood, yet value to academic health centers (AHCs) remains unclear. STUDY DESIGN: A task force from the Association for Academic Surgery Global Affairs Committee and the Society for University Surgeons Committee on Global Academic Surgery designed and disseminated a survey to active US academic global surgeons. Questions included participant characteristics, global surgeon qualifications, trainee interactions, academic output, productivity challenges, and career models. The task force used the survey results to create a position paper outlining the value of academic global surgeons to AHCs. RESULTS: The survey had a 58% (n = 36) response rate. An academic global surgeon has a US medical school appointment, spends dedicated time in an LMIC, spends vacation time doing mission work, or works primarily in an LMIC. Most spend 1 to 3 months abroad annually, dedicating <25% effort to global surgery, including systems building, teaching, research, and clinical care. Most are university-employed and 65% report compensation is equivalent or greater than colleagues. Academic support includes administrative, protected time, funding. Most institutions do not use specific global surgery metrics to measure productivity. Barriers include funding, clinical responsibilities, and salary support. CONCLUSIONS: Academic global surgeons spend a modest amount of time abroad, require minimal financial support, and represent a low-cost investment in an under-recognized scholarship area. This position paper suggests measures of global surgery that could provide opportunities for AHCs and surgical departments to expand missions of service, education, and research and enhance institutional reputation while achieving societal impact.

Public Health Policy and Experience of the 2009 H1N1 Influenza Pandemic in Pune, India.

BACKGROUND: Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness. METHODS: Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune. RESULTS: In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune. CONCLUSION: The World Health Organization's (WHO's) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies.

Metastatic Malignant Thymoma to the Abdomen: A SEER Database Review and Assessment of Treatment Strategies.

BACKGROUND: Thymoma is a neoplasm occurring in 0.15 of 100,000 persons/year. Abdominal metastases are rare. We report the incidence of malignant thymoma (MT) and suggest imaging and treatment options for cases of abdominal metastasis. METHODS: A National Cancer Institute's Surveillance, Epidemiology and End Results database review was conducted to identify MT cases, followed by a literature review examining cases of metastases to the abdomen. Incidence rates were calculated, and symptoms, treatments, size and location of tumors, disease-free interval (DFI), and survival time were recorded. RESULTS: From 1973 to 2008, a total of 1,588 MT cases were identified (45.4 cases/year), which were extrapolated to 2,724 over 60 years. Incidence has risen from 17 cases in 1973 to 90 cases in 2008, with a larger incidence in males than females (0.23 vs. 0.17 per 100,000). There were 25 cases of abdominal metastasis (0.92%), 13 of which were asymptomatic. There was a wide variety of DFI and survival noted amongst the case reports. Multiple treatment modalities were used. CONCLUSIONS: The incidence of MT is on the rise with a male predominance. All patients should receive routine imaging to look for extrathoracic metastases as half will not have symptoms. All patients with abdominal metastases should be treated using a multimodal approach.

Charge-Transfer Dynamics in the Lowest Excited State of a Pentacene-Fullerene Complex: Implications for Organic Solar Cells.

We characterize the dynamic nature of the lowest excited state in a pentacene/C60 complex on the femtosecond time scale, via a combination of ab initio molecular dynamics and time-dependent density functional theory. We analyze the correlations between the molecular vibrations of the complex and the oscillations in the electron-transfer character of its lowest excited state, which point to vibration-induced coherences between the (pentacene-based) local-excitation (LE) state and the complex charge-transfer (CT) state. We discuss the implications of our results on this model system for the exciton-dissociation process in organic solar cells.

Sociocultural determinants of anticipated acceptance of pandemic influenza vaccine in Pune, India: a community survey using mixed-methods.

OBJECTIVES: To investigate community priority and determinants of pandemic influenza vaccine acceptance in Pune, India. Community willingness to accept vaccines is often neglected in pandemic preparedness. Despite an acknowledged need, few such studies have been done in lower income countries. METHODS: A cross-sectional, mixed-methods study used semi-structured explanatory model interviews to assess anticipated acceptance of nasal and injectable vaccines at different prices among 436 urban and rural residents. Logistic regression models identified sociocultural determinants of vaccine acceptance. RESULTS: Over 93 % anticipated acceptance at no-cost; 87.8 % for INR 150 nasal vaccine; 74.1 % for INR 500 and 61.7 % for INR 1000 injectable vaccines. Some respondents preferred low-cost over free vaccines. Illness-related concerns about social isolation, contaminants identified as perceived causes, private-hospital or traditional-healer help seeking, and income were positively associated with anticipated acceptance. Humoral imbalances as perceived cause, home remedies for help-seeking and age were negatively associated. CONCLUSIONS: High acceptability of pandemic influenza vaccines indicates good prospects for mass vaccination. It appeared that confidence was higher in the vaccines than in the health systems delivering them. Vaccination programmes should consider sociocultural determinants influencing vaccine acceptance.

Socio-cultural features and help-seeking preferences for leprosy and turbeculosis: a cultural epidemiological study in a tribal district of Maharashtra, India.

BACKGROUND: India is a major contributor to the global burden of leprosy and tuberculosis (TB), which adversely affects the poorest tribal communities. Despite prioritisation by disease control programmes, programme performance for leprosy and TB in tribal communities continues to be a challenge. In addition to access to services and infrastructural limitations, socio-cultural concepts of illness causation and related help seeking (HS) rooted in distinct features of tribal culture need to be addressed to improve programme outcomes. METHODS: A cultural epidemiological survey of leprosy and TB patients was carried out using a locally adapted, semi-structured explanatory model interviews. A total of 100 leprosy and 50 TB patients registered for treatment at government health facilities were selected randomly from tribal dominant blocks of the Thane district, Maharashtra state. The perceived causes (PCs) of leprosy and TB in patients were compared based on prominence categories. The relationship between PCs as predictors, and disease conditions and HS preferences as outcome variables were assessed using multivariate logistic regression. RESULTS: In the multivariate logistic regression model with disease conditions as outcome variables, TB patients were significantly more likely to report PCs in the categories of ingestion; health, illness and injury; and traditional, cultural and supernatural. Tuberculosis patients more frequently first sought help from private facilities as compared to leprosy patients who preferred government health facilities. In a combined analysis of leprosy and TB patients employing multivariate logistic regression, it was found that patients who reported PCs in the environmental and contact-related categories were more likely to visit traditional rather than non-traditional practitioners. In another multivariate combined model, it was found that patients who reported PCs in the traditional, cultural and supernatural category were significantly more likely to visit private rather than public health facilities. CONCLUSION: Cultural concepts about illness causation and associated HS behaviours should be considered as priorities for action, which in turn would provide the necessary impetus to ensure that tribal patients seek help in a timely and appropriate manner, and could facilitate improvement in programme performance in general.

Community awareness, use and preference for pandemic influenza vaccines in Pune, India.

Vaccination is a cornerstone of influenza prevention, but limited vaccine uptake was a problem worldwide during the 2009-2010 pandemic. Community acceptance of a vaccine is a critical determinant of its effectiveness, but studies have been confined to high-income countries. We conducted a cross-sectional, mixed-method study in urban and rural Pune, India in 2012-2013. Semi-structured explanatory model interviews were administered to community residents (n = 436) to study awareness, experience and preference between available vaccines for pandemic influenza. Focus group discussions and in-depth interviews complemented the survey. Awareness of pandemic influenza vaccines was low (25%). Some respondents did not consider vaccines relevant for adults, but nearly all (94.7%), when asked, believed that a vaccine would prevent swine flu. Reported vaccine uptake however was 8.3%. Main themes identified as reasons for uptake were having heard of a death from swine flu, health care provider recommendation or affiliation with the health system, influence of peers and information from media. Reasons for non-use were low perceived personal risk, problems with access and cost, inadequate information and a perceived lack of a government mandate endorsing influenza vaccines. A majority indicated a preference for injectable over nasal vaccines, especially in remote rural areas. Hesitancy from a lack of confidence in pandemic influenza vaccines appears to have been less of an issue than access, complacency and other sociocultural considerations. Recent influenza outbreaks in 2015 highlight a need to reconsider policy for routine influenza vaccination while paying attention to sociocultural factors and community preferences for effective vaccine action.

Variation in small bowel length: factor in achieving total enteroscopy?

BACKGROUND AND AIM: Estimation of small bowel length is of interest following the recent development of device-assisted enteroscopy. This new technology allows access to the deep small bowel, but rates of examination of the entire small bowel (total enteroscopy) differ between study populations. Variation in small bowel length could factor into this observed irregularity in total enteroscopy rates. Medical literature contains limited information regarding small bowel length in living patients and conflicting data regarding small bowel length and its relationship to height and weight. We carried out small bowel measurements on surgical patients to further define the total length of the small bowel and its relationship to height, weight and body mass index (BMI). METHODS: Measurement of ileojejunal length on 91 surgical patients undergoing laparotomy for routine indications. Demographic data were collected for each subject, including height, weight and BMI. RESULTS: Small bowel length was found to vary widely between individuals (average 998.52 cm, range 630-1510 cm). Linear regression analysis demonstrated a statistically significant relationship between small bowel length and height (regression coefficient = 0.0561, P-value = 0.0238). A linear relationship between small bowel length and weight or BMI was not observed. CONCLUSIONS: Length of the small bowel in humans is pertinent to advances in deep enteroscopy and existing surgical applications such as intestinal bypass and prevention of short gut syndrome. If average small bowel length varies with height, total enteroscopy may be easier to achieve in patients who are short in stature.

Developing and validating a tablet version of an illness explanatory model interview for a public health survey in Pune, India.

BACKGROUND: Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. METHODOLOGY: We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. RESULTS: In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. CONCLUSION: An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies.

Probing vibrationally mediated ultrafast excited-state reaction dynamics with multireference (CASPT2) trajectories.

Excited-state trajectories computed at the complete active space second-order perturbation theory (CASPT2) reveal how vibrational excitation controls the molecular approach to the intersection space that drives the photodissociation of a prototypical halogenated methyl radical, namely CF2I. Translating the Franck-Condon structure along the ground-state CASPT2 vibrational modes in this system followed by propagating the displaced structures in the first excited doublet state simulates specific vibrational excitations and vibrationally mediated dynamics, respectively. Three distinct situations are encountered: the trajectories (i) converge to an energetically flat segment of the intersection space, (ii) locate a segment of the intersection space, and (iii) access a region where the intersection space degeneracy is lifted to form a ridge of avoided crossings. The computational protocol documented herein can be used as a tool to design control strategies based on selective excitation of vibrational modes, including adaptive feedback schemes using coherent light sources.

Leiomyosarcoma of the Inferior Vena Cava - Radical Resection, Vascular Reconstruction and Challenges: A Case Report and Review of Relevant Literature.

Leiomyosarcomas of the inferior Vena Cava (IVC) are rare soft tissue sarcomas accounting for only 0.5% of all soft tissue sarcomas in adults with fewer than 300 cases reported. Extraluminal tumor growth along the adventitia of the IVC seems to be the common presentation. Intraluminal tumor growth is rare. The origin of the tumor is divided into three levels in relation to the hepatic and renal veins. The presentations and surgical modalities vary accordingly. Retroperitoneal tumors are often not diagnosed until the disease is at an advanced stage with large tumor growth and involvement of surrounding structures. This is partly because of the nonspecific clinical presentation as well as absence of early symptoms. Most patients present with abdominal or flank pain. Symptoms vary according to the dimensions of the tumor, growth pattern and localization of the tumor. Radical en bloc resection of the affected venous segment remains the only therapeutic option associated with prolonged survival. The goals of surgical management of these tumors include the achievement of local tumor control, maintenance of caval flow, and the prevention of recurrence. The involvement of renal or hepatic veins determines the strategy for vascular reconstruction. Reconstruction of the IVC is not always required, because gradual occlusion of the IVC allows the development of venous collaterals. However, when pararenal leiomyosarcoma of the IVC is present, reconstruction of the IVC and the renal vein is necessary to prevent transient or permanent renal dysfunction. Recent study has shown that radical surgery combined with adjuvant multimodal therapy has improved the cumulative survival rate. We report a case of IVC leiomyosarcoma in a young healthy woman along with details of its diagnostic workup and discussion of the surgical options and reconstruction of caval continuity.

Neuroendocrine tumors: current recommendations for diagnosis and surgical management.

Neuroendocrine tumors (NETs) are rare neoplasms found in diverse locations within the body. These tumors are commonly classified by the primary tumor's location, further subclassified by their differentiation, and finally segregated by their ability to hypersecrete peptides or amines. A number of groups have summarized their recommendations for diagnosis and therapy; however, the rarity of these lesions makes prospective randomized multiinstitutional trials difficult. Thus, these "consensus statements" often remain opinion-based. The authors have collaboratively developed a consensus on the current diagnostic work-up necessary for patients with NETs to help clinicians with this confusing field and followed this with some of the more advanced surgical techniques and considerations that are currently only available in specialty centers to show the evolving management of NETs.