A highly sensitive method for uranium quantification in water samples at ultra-trace level by total reflection X-ray fluorescence, after its direct pre-concentration on the surface of amidoxime functionalized quartz sample supports.

In this work we have developed a Total reflection X-Ray Fluorescence (TXRF) based methodology for the determination of uranium in natural water samples at ultra-trace concentration level. The methodology involves functionalization of quartz sample supports used for TXRF measurements with (3-Amidoxy) triethoxysilane, which has very high uranium uptake efficiency. (3-Amidoxy) triethoxysilane has been synthesized from (3-Cyanopropyl) triethoxysilane (CPTS). This amidoxime functionalized sample supports, simply needed to be dipped in the uranium solution for 3 h after which, it can be directly taken for TXRF measurements. The developed methodology is very fast, simple with less sample preparation steps involved. The present work utilizes Rayleigh scattered peak to construct the calibration curve for the quantification purpose. The developed methodology has improved accuracy as well as precision for the quantification of uranium at such low concentrations level. The detection limit and accuracy obtained are 0.013 ng/mL (13 ppt) and 1.9%, respectively which are the lowest using any X-Ray Fluorescence based method, to the best of our knowledge. The method was successfully applied for the U determination in natural water samples like ground water, river water and sea water.

γ-Resistant Microporous CAU-1 MOF for Selective Remediation of Thorium.

A simple solvothermal method was used to synthesize a metal-organic framework (MOF) with an Al metal entity, viz., CAU-1 NH2. The synthesized MOF was characterized using different techniques like X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy (SEM), field emission SEM (FE-SEM), transmission electron microscopy, small-angle X-ray scattering, positron annihilation lifetime spectroscopy, and X-ray photoelectron spectroscopy. The radiation stability was evaluated by irradiating the material up to a cumulative dose of 2 MGy using 60Co for the first time. The studies showed a remarkable gamma irradiation stability of the material up to 1 MGy. The porosity and surface area of the synthesized MOF were determined by Brunauer-Emmett-Teller, which showed a high specific surface area of 550 m2/g. The pH dependence study of Th uptake from an aqueous solution was performed from pH 2-8, followed by adsorption isotherm and adsorption kinetics studies. These results revealed that the Langmuir and pseudo-second-order kinetic models can be well adapted for understanding the Th uptake and kinetics, respectively. The synthesized MOF exhibited an ∼404 mg/g thorium adsorption capacity. Selectivity studies of adsorption of Th w.r.t. to U and different metal ions such as Cu, Co, Ni, and Fe showed that Th gets adsorbed preferentially as compared to other metal ions. In addition, the MOF could be used multiple times without much deterioration.

Total Reflection X-ray Fluorescence Spectrometric Analysis of Ten Lanthanides at the Ultratrace Level Having a High Degree of Overlap in the Emission Lines.

The extensive use of lanthanide elements in the medical, electrical, agricultural, and nuclear fields has increased their contamination in the environment. The detrimental effect of lanthanides on human health can be reduced or eliminated by their fast determination in the concerned specimen. For this purpose, an offline conjugation of the cloud point extraction (CPE) process with total reflection X-ray fluorescence (TXRF) spectrometry was done. This process was found to provide simple, quick, and precise simultaneous determination of ten lanthanides whose emission lines have a high degree of overlap at the ultratrace level. N,N,N',N'-tetra-octyl-diglycolamide in triton X-114 micelles was found to offer a selective CPE of all of the lanthanides in the presence of higher concentrations of naturally abundant cations and anions. A multivariative partial least-squares regression (PLSR) calibration approach was preferred due to the complex overlapped spectra of L lines of the lanthanides. Ten lanthanides, viz., La, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Tm, and Lu, were simultaneously determined by this method, having concentrations in the range from 10 to 5 × 103 µg L-1. The proposed method was validated by analyzing three certified reference materials (CRMs), viz., NASS-7 seawater, SRLS-6 river water, and NIST 1640a natural water, via standard addition with the relative standard deviations of ≤10%.

Synthesis and feasibility studies of doping U at Ti site of Y2Ti2O7 as a radioactive waste immobilization matrix.

In pursuit of clean and green nuclear energy one of the major challenges is to effectively immobilize the nuclear waste. In this context A2B2O7 type pyrochlore owing to its structural flexibility, ability to accommodate ions at both A/B-sites and high radiation tolerance has demonstrated excellent capability to store highly radioactive actinide ions. To fill the major gap area of actinide doping at the B site we have taken up the challenge of doping uranium ions at the Ti site of Y2Ti2O7 type pyrochlore. An yttria titanate (Y2Ti2-xUxO7; x = 0.05, 0.075, 0.1, 0.2, and 0.3) based matrix with uranium doped at the Ti site was synthesized using a simple gel combustion route under an air atmosphere. Rietveld refined X-ray diffraction (XRD) demonstrated that Y2Ti2O7 can accommodate U up to 5 mol% in the Ti site without any phase separation, which was further confirmed using Raman spectroscopy. Y2Ti2O7 based matrices are found to be radiation stable up to 1000 kGy and at the same time they are moderately thermally stable and on a par with the values reported for pyrochlores. Uranium in Y2Ti2O7 stabilizes in +6 oxidation state in the form of uranyl ion distributed near and far off from titanium vacancies with distinct excited state lifetime. This work could provide a smart and strategic way for selecting a suitable advanced ceramic matrix for immobilization of high level waste with additional and important information on solubility limit, actinide speciation, radiation/thermal stability, actinide concentration, etc.

Bibliometric Analysis and Methodological Review of Mobile Health Services and Applications in India.

PURPOSE: The purpose of this research is to analyze the literature published on mobile health (mHealth) in the Indian context. It also reviews the most important research works and presents various methodologies adopted by the researchers in this domain. DESIGN/METHODOLOGY/APPROACH: The SciVerse SCOPUS database was used for extracting the literature on mobile health. The study used articles published between January 2008 to 28th June 2019. The keyword used is 'mHealth' and journal articles with studies or interventions carried out in India were selected for bibliometric analysis and methodological review. FINDINGS: For the keyword search, a total of 7,874 documents have been extracted, of which only 158 have been considered for the analysis. There is an exponential increase in the number of publications from the year 2015 to 2019. The keywords used for representing their articles have been grouped as mobile health devices, gender and age groups, system and software, health and disease condition, management, evidence-based practices (outcome), methods, and importance of the study. The journal PLOS One (87) has the highest number of citations, followed by The Lancet (63). The bibliometric analysis of the literature revealed seven clusters classified as individual's individual's mobile health applications adoption characteristics, need for mobile health and its governance, mobile phone application with the internet of things based framework for healthcare monitoring, mobile health for primary healthcare systems, authentication and security protocol for mobile healthcare, development and experimentation of mobile health application, and development and mobile health for adherence support intervention. ORIGINALITY/VALUE: The study contributes in analyzing the bibliometrics and provides a methodological review for the journal articles published on mobile health. Previous articles considered systematic analysis of the bibliometric for mHealth, and mobile technology but less adequately discussed specifically towards Indian context which this study has embraced.

Recommendations for Safely Performing Major Head and Neck Surgery During the COVID-19 Pandemic: Experience with Implementation of a Workflow.

COVID 19 pandemic has affected the delivery of surgical services as a part of management of head and neck cancers all over the world. Since it may affect the overall cure as well as quality of life of these patients, it is necessary to continue providing surgical treatment but with minimal additional health hazards to the patient or the health care worker. For this, a workflow was formulated in a university teaching hospital in India with large head and neck cancer workload and implemented during the period of national lockdown. 125 major head and neck cancer cases were operated during this period out of which 25 patients were of high-risk status. Emergency (10%) and semi-emergency (83%) cases predominated with few electives. The number of noncancer reconstructive and craniomaxillofacial cases operated was 81, out of which 25% was of emergency in nature. When compared to the data of similar period in the previous year, 60% of the workload in the cancer-related cases could be offered surgical treatment, whereas the noncancer cases operated were only 25%. The workflow may be useful for all surgical departments in safely performing procedures during this pandemic or similar situations in future with suitable refinements.

Waiting for Godot: A cross sectional survey based analysis of the hydroxychloroquine prophylaxis strategy against COVID-19 in India.

Background: India currently has the second largest burden of infections due to COVID-19. Health Care Worker (HCW) shortages are endemic to Indian healthcare. It should therefore be a huge priority to protect this precious resource as a critical component of the systemic response to this pandemic. Advisories from the Indian Council of Medical Research (ICMR) have focused on using hydroxychloroquine prophylaxis against COVID-19 in at risk HCW. This prophylaxis strategy has no evidence. In further jeopardy there appear to insubstantial attempts to build this evidence as well. In this connection, we commissioned a survey within our Institution to estimate the penetration of hydroxychloroquine (HCQ) use and use this to statistically model the impact of current ongoing studies in India. We also briefly review the literature on HCQ prophylaxis for COVID-19. Design and methods: A structured survey designed using RedCAP application was disseminated among healthcare professionals employed at an academic referral tertiary care centre via online social media platforms. The survey was kept open for the entire month of June 2020. The survey was additionally used to statistically model the size of studies required to comprehensively address the efficacy of HCQ in this setting. Results: 522 responses were received, of which 4 were incomplete. The ICMR strategy of 4 or more doses of HCQ was complete only in 15% of HCW in our survey. The majority of respondents were doctors (238, 46%). Amongst all category of responders, only 12% (n=63) received the full course. A majority of those who initiated the chemoprophylaxis with HCQ turned out to be medical professionals (59/63) with neither nurse nor other categories of healthcare workers accessing the medication. The respondents of our institutional survey did not report any life-threatening side effects. Presuming efficacy as per ICMR modelling for new registry trial on the lines of the published case control study, equal allocation between cases and controls and assuming a RR of 1.3.6, the power of such a study would be very low for n=2000 for event rates from 2.5-12.5%. Conclusion: We report the low penetration of HCQ chemoprophylaxis among the healthcare workers of our institution. We highlight the inherent drawbacks in the study design of current national COVID related trial based on the statistical modelling of our survey results and published literature, and thereby emphasis the need of evidence-based strategies contributing to research policy at national level.

Assessing mobile health applications with twitter analytics.

INTRODUCTION: Advancement in the field of information technology and rise in the use of Internet has changed the lives of people by enabling various services online. In recent times, healthcare sector which faces its service delivery challenges started promoting and using mobile health applications with the intention of cutting down the cost making it accessible and affordable to the people. OBJECTIVES: The objective of the study is to perform sentiment analysis using the Twitter data which measures the perception and use of various mobile health applications among the citizens. METHODS: The methodology followed in this research is qualitative with the data extracted from a social networking site "Twitter" through a tool RStudio. This tool with the help of Twitter Application Programming Interface requested one thousand tweets each for four different phrases of mobile health applications (apps) such as "fitness app", "diabetes app", "meditation app", and "cancer app". Depending on the tweets, sentiment analysis was carried out, and its polarity and emotions were measured. RESULTS: Except for cancer app there exists a positive polarity towards the fitness, diabetes, and meditation apps among the users. Following a system thinking approach for our results, this paper also explains the causal relationships between the accessibility and acceptability of mobile health applications which helps the healthcare facility and the application developers in understanding and analyzing the dynamics involved the adopting a new system or modifying an existing one.

A Quality Improvement Initiative to Reduce "Out-of-ICU" Cardiopulmonary Arrests in a Tertiary Care Hospital in India: A 2-Year Learning Experience.

QUALITY PROBLEM OR ISSUE: To assess impact of medical emergency team (MET) in reducing "out-of-ICU" cardiopulmonary arrests and identify barriers to its optimal utilization. INITIAL ASSESSMENT: Frequently observed critical clinical signs and laboratory values of "out-of-ICU" crashes were used to develop Amrita Early Warning Criteria. CHOICE OF SOLUTION: A physician-led MET was established to respond to code MET, activated by a primary nurse. IMPLEMENTATION: Rates of "out-of-ICU" cardiopulmonary arrests per 1000 admissions were compared in pre-MET (2013-2014) and post-MET periods (2014-2016) along with disposition following MET and mortality. Descriptive statistics and logistic regression were used for comparative analysis. EVALUATION: For continued quality improvement, a Likert agreement scale questionnaire collated the nurse's feedback on MET. 386 Code MET were recorded with an activation rate of 18.8 per 1000 inpatients for 2014-2016. Common MET triggers were desaturation (53%), seizure (10%), and syncope (9%). Seventy-one percent of activations were attended within 5 minutes, with 45% reported during nurse's night shift hours. Medical emergency team interventions resulted in 59% being shifted to ICU. In the "post-MET" period, "Cold Blue" dose reduced from 6.9 in 2013-2014 to 2.6 (P = .0002) in 2014-2015 and 3.2 (P = .01) in 2015-2016. Ninety-three percent of the Code Blues with prior MET calls were "delayed MET" and 28% of the Code Blues without prior MET activation were "missed MET." Nurse's feedback revealed that 46% lacked knowledge of correct MET activation process while 31% expressed a fear of reprisal for inappropriate activation. LESSONS LEARNED: Although MET intervention was successful in significantly reducing "out-of-ICU" Code Blues, focused training of nurses is required for continued quality improvement.

Mechanism of CO + N2O reaction via transient CO3(2-) species over crystalline Fe-substituted lanthanum titanates.

Some newer mechanistic aspects investigated by in situ Fourier transform infrared (FTIR) in conjunction with catalytic activity under similar conditions over crystalline lanthanum titanates as a function of Fe substitution at the B-site for the CO + N(2)O reaction are reported for the first time in the present communication. La(2)Ti(2(1-x))Fe(2x)O(7-delta) (0.0 < or = x < or = 1.0) was synthesized by gel combustion where Fe(3+) substitution effectively enhanced the conversion rates for N(2)O reduction as compared to the pristine La(2)Ti(2)O(7) (LTOGC). Among all samples, maximum conversion over La(2)Ti(0.8)Fe(1.2)O(7-delta) [LF(0.6)GC] catalyst was observed. In situ FTIR results reveal that substitution-induced anionic vacancies/defects provide additional sites on the surface of LF(0.6)GC for CO chemisorptions, whereas a perfect stoichiometric lattice like LTOGC is devoid of such sites. Surface-adsorbed CO reacts with surface lattice oxygen in the case of nonstoichiometric LF(0.6)GC to produce carbonates (M-CO(3)(2-)) at a much lower temperature. The reaction proceeds via carbonate formation, leaving the catalytic surface oxygen deficient in LF(0.6)GC, and therefore facilitates the reduction of preadsorbed, N(2)O [N(2)O(g) + * --> N(2) + *-O) by easily adsorbing the oxygen species (*-O) generated in N(2)O reduction, which is subsequently driven away by adsorbed/gas phase CO, whereas in the case of LTOGC, progress of the reaction was sluggish in the absence of transient carbonate species. Dissociative chemisorptions of N(2)O are not facilitated on stoichiometric oxygen excess titanate, as there is no vacancy in the surface to accommodate another oxygen atom. The redox mechanism via CO(3)(2-) species is proposed for CO + N(2)O reaction over La(2)Ti(2(1-x))Fe(2x)O(7-delta), as against the associative mechanism observed in the unsubstituted sample, La(2)Ti(2)O(7), as suggested by in situ FTIR in conjunction with catalytic activity results.