Search

Background: Health care providers worldwide are rapidly adopting electronic medical record (EMR) systems, replacing paper record-keeping systems. Despite numerous benefits to EMRs, the environmental emissions associated with medical record-keeping are unknown. Given the need for urgent climate action, understanding the carbon footprint of EMRs will assist in decarbonizing their adoption and use., Objective: We aimed to estimate and compare the environmental emissions associated with paper medical record-keeping and its replacement EMR system at a high-volume eye care facility in southern India., Methods: We conducted the life cycle assessment methodology per the ISO (International Organization for Standardization) 14040 standard, with primary data supplied by the eye care facility. Data on the paper record-keeping system include the production, use, and disposal of paper and writing utensils in 2016. The EMR system was adopted at this location in 2018. Data on the EMR system include the allocated production and disposal of capital equipment (such as computers and routers); the production, use, and disposal of consumable goods like paper and writing utensils; and the electricity required to run the EMR system. We excluded built infrastructure and cooling loads (eg. buildings and ventilation) from both systems. We used sensitivity analyses to model the effects of practice variation and data uncertainty and Monte Carlo assessments to statistically compare the 2 systems, with and without renewable electricity sources., Results: This location's EMR system was found to emit substantially more greenhouse gases (GHGs) than their paper medical record system (195,000 kg carbon dioxide equivalents [CO 2 e] per year or 0.361 kg CO 2 e per patient visit compared with 20,800 kg CO 2 e per year or 0.037 kg CO 2 e per patient). However, sensitivity analyses show that the effect of electricity sources is a major factor in determining which record-keeping system emits fewer GHGs. If the study hospital sourced all electricity from renewable sources such as solar or wind power rather than the Indian electric grid, their EMR emissions would drop to 24,900 kg CO 2 e (0.046 kg CO 2 e per patient), a level comparable to the paper record-keeping system. Energy-efficient EMR equipment (such as computers and monitors) is the next largest factor impacting emissions, followed by equipment life spans. Multimedia Appendix 1 includes other emissions impact categories., Conclusions: The climate-changing emissions associated with an EMR system are heavily dependent on the sources of electricity. With a decarbonized electricity source, the EMR system's GHG emissions are on par with paper medical record-keeping, and decarbonized grids would likely have a much broader benefit to society. Though we found that the EMR system produced more emissions than a paper record-keeping system, this study does not account for potential expanded environmental gains from EMRs, including expanding access to care while reducing patient travel and operational efficiencies that can reduce unnecessary or redundant care., (©Cordelia Kwon, Lernik Essayei, Michael Spencer, Tom Etheridge, Rengaraj Venkatesh, Natrajan Vengadesan, Cassandra L Thiel. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.02.2024.)

Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators.

This article questions the economic rationale of colonial experimentation and prison labor, arguing that for many administrators a prison-based experiment's success mattered less than its existence. It examines the position of convict labor and penal discipline within colonial industrial experiments in colonial India, where convicts performed experiments for what one administrator described as "the most penal" form of labor, papermaking. The belief that Indian fibers could open a new export market for global papermaking meant that prisons became prominent sites of experimentation with new pulps. Regional prisons gained state monopolies for handmade paper, often decimating local independent producers. Yet prison and industrial officers counterintuitively positioned the frequent failures of papermaking experiments as a continuing potential source for industrial improvement. They argued that the failures demonstrated the need to improve discipline and supervision. Prison experiments slotted convicts into repetitive, mechanized roles that served European investigations into the utility of Indian products.

The study attempted to evaluate the agricultural soil quality using the Soil Quality Index (SQI) model in two Community Development Blocks, Ausgram-II and Memari-II of Purba Bardhaman District. Total 104 soil samples were collected (0-20 cm depth) from each Block to analyse 13 parameters (bulk density, soil porosity, soil aggregate stability, water holding capacity, infiltration rate, available nitrogen, available phosphorous, available potassium, soil pH, soil organic carbon, electrical conductivity, soil respiration and microbial biomass carbon) in this study. The Integrated Quality Index (IQI) was applied using the weighted additive approach and non-linear scoring technique to retain the Minimum Data Set (MDS). Principal Component Analysis (PCA) identified that SAS, BD, available K, pH, available N, and available P were the key contributing parameters to SQI in Ausgram-II. In contrast, WHC, SR, available N, pH, and SAS contributed the most to SQI in Memari-II. Results revealed that Ausgram-II (0.97) is notably higher SQI than Memari-II (0.69). In Ausgram-II, 99.72% of agricultural lands showed very high SQI (Grade I), whereas, in Memari-II, 49.95% of lands exhibited a moderate SQI (Grade III) and 49.90% showed a high SQI (Grade II). Sustainable Yield Index (SYI), Sensitivity Index (SI) and Efficiency Ratio (ER) were used to validate the SQIs. A positive correlation was observed between SQI and paddy ( R 2  = 0.82 & 0.72) and potato yield (R 2  = 0.71 & 0.78) in Ausgram-II and Memari-II Block, respectively. This study could evaluate the agricultural soil quality and provide insights for decision-making in fertiliser management practices to promote agricultural sustainability., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The BRICS countries-Brazil, Russia, India, China, and South Africa-are committed to achieving United Nations Sustainable Development Goal 13, which focuses on mitigating climate change. To attain this goal, it is crucial to emphasize the significance of ICT, renewable energy sources, industrialization, and institutional quality. This study contributes to the literature by examining the potential role of these factors in environmental sustainability in the BRICS economies from 2000 to 2021, utilizing cross-sectional augmented autoregressive distributed lag (CS-ARDL) estimation and other novel econometric techniques. Accordingly, the study suggests that BRICS governments and policymakers prioritize the use of ICT in the industrial and institutional sectors to achieve faster environmental sustainability in the short-run, as per the CS-ARDL results. However, the study advises caution in the long-term as the interaction between ICT and renewable energy sources, industrialization, and institutional quality may not favour environmental quality. Although the renewable energy sources interaction with ICT may not yield immediate progress, strong measures need to be taken to ensure that short-term gains are not nullified. In conclusion, the study highlights the potential of ICT, renewable energy sources, industrialization, and institutional quality in achieving environmental sustainability in the BRICS countries, while recommending cautious measures in the long run to safeguard the progress made., (© 2024. The Author(s).)

Background: Catfishes (order Siluriformes) are among the most diverse and widely distributed fish groups in the world. They are not only used for human consumption but are also a major part of the ornamental fish trade. Being a Biodiversity Hotspot, the North Eastern Region of India is home to a diverse population of ornamental fishes. Catfishes contain a humongous number of species; in this study, the authors have tried to elucidate the phylogenetic relationship of some important ornamental catfishes found in North East India using DNA barcodes., Methods and Results: In this study, we have tried to explore the phylogenetic history of 13 species (41 specimens) of ornamental catfishes spanning 12 genera and 9 families of Siluriformes using DNA barcoding. Pairwise genetic distances using Kimura 2-Parameter (K2P) were calculated at intra-specific and inter-specific levels. A Neighbor-Joining tree was constructed to understand the phylogenetic relationship among the nine different catfish families. All the specimens under this study clustered with their respective species under the same family and formed three sub-clades. However, Olyra longicaudata, belonging to the Bagridae family, did not cluster with other species from the same family. In this study, the authors have suggested a revision of the classification of O. longicaudata back to its original family, Olyridae., Conclusions: In this study, the maximum intraspecific genetic distance of 0.03 and the minimum interspecific genetic distance of 0.14 were observed among the species. Therefore, it is evident that there is a barcoding gap among the species, which helped in the correct identification of the species. Thus, DNA barcoding helped complement the phenetic approach and also revealed a different phylogenetic relationship among the catfishes belonging to the Bagridae family., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Acute liver failure (ALF) is an infrequent, but serious complication subsequent to severe acute liver injury (sALI) due to various hepatotoxic agents such as hepatotropic virus(es) and drugs such as anti-tubercular medications, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics and anti-cancer and anti-epileptic therapy and due to metabolic and autoimmune disease flares. ALF after sALI presents with encephalopathy associated with prolonged international normalized ratio (INR). Mortality in ALF is high and ranges between 50% and 80%. Due to severe liver damage, multiple sequels consequent to hepatic dysfunction result in complications such as hyperammonemia that culminates in encephalopathy associated with cerebral edema; innate immune paralysis resulting in increased frequency of infections and endotoxemia causing decrease in systemic vascular resistance (SVR) and tissue hypoperfusion and damage-associated molecular patterns (DAMPs) released from damaged hepatic parenchyma inducing pro-inflammatory cytokine storm, which may cause other organ dysfunctions. Certain etiologies such as hepatitis E virus and hepatitis A virus-related ALF or paracetamol-ALF (hyper-acute presentation) have better survival than remaining causes. In addition, if etiology-specific treatment (antivirals for ALF related to hepatitis B virus (HBV) or Herpes simplex virus (HSV) or N-acetylcysteine for paracetamol) is available, then the outcome with treatment is better. About half of the patients can be salvaged with medical therapy. All patients need intensive care and organ support to provide time for the liver to regenerate. Various prognostic models to predict high probability of mortality have been described, which should be used to select patient early during the disease for liver transplantation, which is associated with high long-term survival in these sick patients. The Indian National Association for Study of the Liver (INASL) recommends the ALF-Early Dynamic (ALFED) model as a preferred prognostic model in the Indian scenario, where hepatitis viruses are a dominant etiology of ALF and occur on a naïve liver with good regenerative capacity., (© 2024. Indian Society of Gastroenterology.)

This paper analyses findings of the 'PROWELLMIGRANTS' 2 project, which qualitatively investigated COVID-19 impacts on migrants' well-being and mental health in Kerala, India. It draws on a novel conceptual framework that combines assemblage-thinking with theories of social contracts in disasters. The paper first explores how past development processes and contemporary migration policies in Kerala, and India more widely, generated conditions of vulnerability for migrant workers in Kerala prior to the pandemic. Next it shows that Government of Kerala interventions, in some cases supported by the central Government of India, temporarily addressed these vulnerabilities during the pandemic. In acknowledging the helpful response of the Kerala government, we problematise its stance on migrant workers during 'normal' times and speculate that permanently addressing these conditions of vulnerability would be a more logical approach. We acknowledge this involves overcoming many wider barriers. Thus, the paper also contains national-level policy implications., (© 2023 The Authors. Disasters published by John Wiley & Sons Ltd on behalf of ODI.)

Asian countries are facing difficulties in attaining sustainable development goals (SDGs), and India is not an exception to it, with environmental degradation being one of the primary issues. Therefore, a policy-level reorientation may be required to address it. From this standpoint, fiscal policy instruments may come in handy towards fully integrating the SDGs into its agenda. The present investigation designs an SDG framework for India that could serve as an example for other Asian nations. This study introduces a new investigation exploring the relationship between fiscal policy instruments and environmental quality in India by examining the environmental Kuznets curve (EKC) hypothesis from 1990 to 2021. A nonlinear autoregressive distributed lag (NARDL) model is applied for empirical examination. The findings indicate that positive and negative shocks in fiscal policy instruments have significant impact on carbon emissions in both the long and short run. The study has also found evidence of an "inverted U-shape" EKC for India. These results are valuable from a policy perspective for India and other Asian countries to address environmental issues. The study has also outlined potential outcomes that may benefit India's fiscal policy in resolving environmental issues and attaining better economic growth. In the end, the study proposes a policy framework that supports SDG 7, SDG 8, SDG 12, SDG 13, and SDG 17 objectives., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Changing climate exerts significant pressure on coastal wetland fishery, ecosystems and livelihood at the eco-regional level. In the present study, an indicator and scoring-based vulnerability assessment framework was developed to assess climate change-induced potential impacts and vulnerability of the coastal wetlands through stakeholder perception and primary data collection on ecology and fisheries. The study was conducted in 12 coastal wetlands in the Gangetic estuarine regions of eastern India. Analysis of rainfall, temperature and extreme climatic events was also carried out. The climate variability in the region was analysed and discussed in the context of ecosystem health and sustainability indicators. The results indicated that anthropogenic stress has a greater influence on ecosystem services than climatic stress. However, the nature and degree of vulnerability of fishers to climate change vary with their capacity to adapt to such changes and alternate sources of livelihood. Altogether, 34 fish species were documented, belonging to 11 taxonomic orders, and categorized as per intensity of resilience using selected criteria. Perception-based climate-resilient adaptation strategies have also been discussed. Developing appropriate adaptation policies and implementing climate-resilient practices and management can minimize vulnerability and increase the adaptive capacity of fishers ensuring sustainable livelihood options., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)