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This article discusses the preparation of different grades of single-ion conducting quasi-solid polymer electrolytes (q-SPE) material (Chit-g-SPA-IL) based on biopolymer (chitosan), polyacrylic acid and DBU-acetate (DBUH + AcO - ) ionic liquid. Chit-SPA-60 %-IL exhibited the highest conductivity within the range of 10 -4  S/cm. TGA analysis demonstrated the stability of electrolytes up to a temperature of 120 °C. SEM-EDS analysis unveiled the porous nature of the electrolyte and even distribution of ions throughout the matrix. It exhibited an electrochemical stability window (EWS) of 2.53 V with significant current density and an ionic transference number (ITN) of ~99.9 %. The temperature-dependent conductivity established an Arrhenius-type conduction mechanism with an activation energy of 0.149 eV for ion movement within the electrolyte matrix. The AC conductivity analysis emphasized the time-temperature independence of the ionic conduction mechanism. Dielectric analysis highlighted the capacitive nature of the electrolyte, underlining its substantial capacitance, while modulus studies indicated minimal influence from the electrode-electrolyte interface. Chit-SPA-60 %-IL at 30 °C included a self-diffusion coefficient of 4.57 × 10 -5  m 2 /s, ionic mobility of 1.75 × 10 -3  m 2 /Vs, and drift ionic velocity of 0.44 m/s. These findings makes SPE as a promising candidate for sodium-ion-based energy storage devices., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In this study, we demonstrated that arranging positive and negative capacitance materials in series, based on isomeric polythiophene, led to a notable increase in total capacitance. Furthermore, the application of negative capacitance (NC) technology in supercapacitor (SC) construction offers the potential for energy storage capabilities surpassing fundamental limits. Our findings suggest the feasibility of developing all-organic based energy storage devices with high capacitance.

Interlayer excitons (IXs) in van der Waals heterostructures with static out of plane dipole moment and long lifetime show promise in the development of exciton based optoelectronic devices and the exploration of many body physics. However, these IXs are not always observed, as the emission is very sensitive to lattice mismatch and twist angle between the constituent materials. Moreover, their emission intensity is very weak compared to that of corresponding intralayer excitons at room temperature. Here we report the room-temperature realization of twist angle independent momentum direct IX in the heterostructures of bulk PbI 2 and bilayer WS 2 . Momentum conserving transitions combined with the large band offsets between the constituent materials enable intense IX emission at room temperature. A long lifetime (∼100 ns), noticeable Stark shift, and tunability of IX emission from 1.70 to 1.45 eV by varying the number of WS 2 layers make these heterostructures promising to develop room temperature exciton based optoelectronic devices.

To meet the growing international demand for aromatic rice, this study, conducted at Uttar Banga Krishi Viswavidyalaya in Cooch Behar, West Bengal, aimed to enhance the yield and quality of the 'Tulaipanji' rice cultivar through advanced establishment methods and the use of organic nutrients over two years. The research tested three planting techniques: mechanical transplanting, wet direct seeding (using a drum seeder), and traditional methods, alongside four nutrient management strategies: vermicompost, farmyard manure, a mix of both, and conventional fertilizers. Findings revealed that mechanical transplanting significantly increased yield by over 31.98% and 71.05% compared to traditional methods and wet direct seeding, respectively. Using vermicompost alone as a nutrient source not only boosted yields by 21.31% over conventional fertilizers but also enhanced the rice's nutritional value and cooking quality. Moreover, soils treated with vermicompost showed higher dehydrogenase activity, indicating better soil health. Economically, mechanical transplanting with vermicompost was the most beneficial, yielding the highest net returns and benefit-cost ratios in both years studied. This approach presents a viable model for improving the sustainability of aromatic rice production globally, emphasizing the economic and environmental advantages of adopting mechanical planting techniques and organic fertilization methods., (© 2024. The Author(s).)

Background: Experiences of delayed conception and infertility have been reported among women. However, the concept of intersectionality is rarely utilised in studies of infertility, and it is particularly uncommon in research from low- and middle- income countries., Research Question: What are the lived experiences of women with delayed conception in low to -middle income neighbourhoods of Delhi, India?, Methods: This was a qualitative study (n = 35) that recruited women who had failed to conceive after 18 months of regular unprotected sexual intercourse. Data were collected between February and July 2021. Data were collected through focus group discussions in low income to middle income neighbourhoods of Delhi, India. Analysis identified themes related to intersecting axes of inequality., Results: The results showed that gender intersected with economics, masculinity, patriarchal norms and class to influence the experiences of women. The intersection of gender, economics and patriarchal norms compromised women's agency to be active generators of family income, and this dynamic was exacerbated by patrilocal residence. In addition, masculinity contributed to stigmatisation and blaming of women, due to the inaccurate perception that men did not contribute to a couple's infertility. The intersection of gender and social class in medical settings created barriers to women's access to medical information., Conclusion: Findings from this study provide representative examples of the variety of axes of inequality that shape women's experiences in the study setting. Although these findings may not be generalisable to all women who are experiencing delayed conception, they highlight a need for improved awareness and education on infertility, as well as a need to ensure the availability and accessibility of fertility care for couples in need., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Adhikary et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Gestational diabetes mellitus (GDM) is a prevalent condition with an unclear pathogenesis. B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) are potential key players in GDM., Participants, Materials, and Methods: In a longitudinal observational study, we monitored women from the first trimester through 24-28 weeks of gestation, focusing on the development of GDM. Serum levels of BAFF and APRIL, as well as their mRNA expression, were evaluated in both the first and third trimesters. Furthermore, we assessed cytokines, adipokines, and placental hormones in the serum., Results: In the first trimester, participants who later developed GDM exhibited elevated serum BAFF and reduced serum APRIL levels, although the mRNA expression of these molecules was similar to controls. Serum BAFF exhibited significant positive correlations with metabolic markers and placental hormones. Conversely, serum APRIL was negatively correlated with insulin resistance and inflammatory markers but positively correlated with adiponectin. In the early third trimester, GDM participants continued to display higher serum BAFF levels and lower serum APRIL levels than controls. There was no significant difference in mRNA expression of BAFF between GDM and control groups. Conversely, APRIL mRNA expression was significantly lower in the GDM group. The predictive potential of first-trimester BAFF and APRIL levels for future GDM development was explored, with both molecules demonstrating strong predictive capability., Discussion and Conclusion: This study suggests that elevated serum BAFF and reduced serum APRIL levels during pregnancy may be associated with the development of GDM. These biomarkers can serve as potential early predictors for GDM., (Copyright © 2024 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)

Background: Mental health is a growing concern worldwide. It is not well understood whether international labour migrants from Nepal who return to Nepal are at higher risk of developing mental health problems. The purpose of our study was to determine the prevalence of and examine the associated factors for depressive symptoms among returnee migrants and non-migrant working male adults in Nepal., Methods: A cross-sectional survey of a probability-based sample of 725 participants was conducted in February 2020. The sample was comprised of two groups based on migration status: returning migrants and non-migrants. The 21-item Beck Depression Inventory (BDI-21) questionnaire was used to assess depressive symptoms. Logistic regression was applied to investigate factors associated with symptoms of depression., Results: The overall prevalence of depressive symptoms was 10.1%. However, the prevalence of depressive symptoms was lower (7%) among returnee migrants compared to non-migrants (13.7%). Men in the lower income group had a higher chance of having depressive (AOR = 5.88, 95% CI: 2.17-15.96) than those in the higher income group. Similarly, Buddhists and Christians were more likely to be depressed (AOR = 2.20, 95% CI: 1.03-4.68) than Hindus. Participants with more than two children had a higher chance of having of depressive symptoms (AOR = 4.80, 95% CI: 1.15-20.05) compared with those without children. Unmarried men were more likely to be depressed (AOR = 4.07, 95%, CI:1.11-14.92) than those who were married., Conclusion: The working Nepali adult male population in Nepal, including returning migrants, is at risk of depressive symptoms, but this association was lower in those in the higher income group, returnee migrants, those who were married, Hindus and those with no children. Our results highlight the need to monitor and develop national policies to ensure the mental health of the Nepali male adult population, including returnee migrants., (© 2024. The Author(s).)

Here, spherical Mn 2 O 3 nanozymes were synthesized via a one-step green method using different green precursors, and their physicochemical properties and biological activities were monitored with various green precursors. Powder X-ray diffraction (PXRD) was performed to determine the crystalline properties and phases involved in the formation of cubic Mn 2 O 3 nanozymes. The synthesized nanozymes were spherical and examined by SEM and FESEM studies. All of the samples synthesized using different green precursors exhibited different sizes but similar spherical shapes. Moreover, all green-synthesized nanozymes catalyzed the oxidation reaction of the chromogenic substrate 3,3'5,5' tetramethylbenzidine (TMB) in the absence of H 2 O 2 , and A2 (lemon-mediated Mn 2 O 3 nanozymes), which the followed Michaelis-Menten kinetics, showed the best activity. Therefore, A2 (lemon-mediated nanozyme) showed oxidase-mimicking activity with distinct K m and V max values calculated by the Lineweaver-Burk plot. Furthermore, the current nanozymes demonstrated a significant ability to kill both Gram-negative and Gram-positive bacteria as well as effectively destroy biofilms under physiological conditions. Moreover, the green-mediated nanozymes also displayed ROS-scavenging activity. Our nanozymes exhibited scavenging activity toward OH and O 2 -• radicals and metal chelation activity, which were investigated colorimetrically. Therefore, these nanozymes might be used as effective antibacterial agents and also for the consumption of reactive oxygen species.

Objective: Non-obese type 2 diabetes seems to be common in India; hence the current study tried to understand the pathogenesis of diabetes in this group focusing on the role of adipocytes especially abdominal fat compartment. Comparison was made between non-obese subjects with newly detected diabetes and those without diabetes, in relation to levels of adipogenic factor and adipokines in pre-adipocytes and mature adipocytes respectively., Research Design Methods: Non-obese subjects (BMI-18-25 Kg/m 2 ) were consecutively selected of whom 15 had newly-detected, treatment naïve type 2 diabetes (HbA1% ≥6.5) while 25 were control (HbA1c% ≤5.6). We examined the expression of adipocyte differentiation factor - SREBP-1c from preadipocytes and adipocyte specific adipokines- HMW isoform and total adiponectin, leptin, FABP-4, TNF-α and IL-6 from adipocytesisolated from abdominal visceral and subcutaneous adipose tissues (VAT and SCAT) by RT-PCR and as well as from serum by ELISA. Size of cultured adipocytes was measured in a fully automated imaging system microscope., Result: Both in SCAT and VAT, SREBP-1c and adiponectin had significantly lower expression along with increased mRNA level of inflammatory adipokinesdiabetes.Average adipocyte size and frequency of large(hypertrophied) adipocytes were comparatively higher in T2DM subjects and had significant negative correlation with SREBP-1c. HMW adiponectin level significantly reduced in the secretion from VAT and SCAT of T2DM subjects compared to control., Conclusion: Reduced expression of SREBP-1c in preadipocytes may lead to increased number of hypertrophied adipocytes in T2DM. Therefore, these dysfunctional hypertrophied adipocytes could cause imbalanced expression of insulin resistant and insulin sensitive adipokines., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this investigation, we present empirical observations detailing the manifestation of substantial negative capacitance (NC), reaching up to -1 F, within iodine-doped isomeric polythiophene (IPTh-I 2 ). NC observed in our case is not transient but stable enough to be measured for as long as the optimum concentration of the iodine dopant is available. In contrast, undoped isomeric polythiophene (IPTh) manifests a modest positive capacitance ranging from 30 to 60 μF. The concatenation of IPTh-I 2 and IPTh in the series results in an augmentation of the total capacitance of the system (∼170 μF), exemplifying a characteristic feature of NC. Conversely, a bilayer configuration consisting of IPTh:IPTh exhibits a reduction in total capacitance by 38%. A notable amplification in the dielectric constant, escalating from 30 in IPTh to approximately 2000 in IPTh-I 2 , signifies extensive conformational and structural alterations arising from interactions between the doped polymer chain and various iodide species, attributing to the emergence of NC. Furthermore, we document a single-sided p-n junction diode with a low knee voltage (below 0.5 V) as a model device, illustrating the potential of IPTh as a promising material for the design and development of negative capacitance-based field-effect transistors. This research offers avenues for the scientific community to conceive low knee voltage-operating diodes, transistors, supercapacitors, and various other electronic devices based on all-organic semiconductors.

Background: Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country's move to federalism on its health system, we reflect on the method's strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach's strengths and challenges. Findings on the impact of federalism on the health system are beyond the scope of this manuscript., Main Body: We conducted PPA workshops with a wide range of health system stakeholders (political, administrative and service-level workforce) at the local and provincial levels in Nepal. The workshops consisted of three activities: river of life, brainstorming and prioritization, and problem-tree analysis. Our experiences show that PPA workshops can be a valuable approach to explore health policy and system issues - especially in a context of widespread systemic change which impacts all stakeholders within the health system. Effective engagement of stakeholders and activities that encourage both individual- and system-level reflections and discussions not only help in generating rich qualitative data, but can also address gaps in participants' understanding of practical, technical and political aspects of the health system, aid policy dissemination of research findings, and assist in identifying short- and long-term practice and policy issues that need to be addressed for better health system performance and outcomes. Conducting PPA workshops is, however, challenging for a number of reasons, including the influence of gatekeepers and power dynamics between stakeholders/participants. The role and skills of researchers/facilitators in navigating such challenges are vital for success. Although the long-term impact of such workshops needs further research, our study shows the usefulness of PPA workshops for researchers, for participants and for the wider health system., Conclusions: PPA workshops can effectively generate and synthesize health policy and system evidence through collaborative engagement of health system stakeholders with varied roles. When designed with careful consideration for context and stakeholders' needs, it has great potential as a method in health policy and systems research., (© 2024. The Author(s).)

Cancer immunotherapy targeting adaptive immune cells has been attracting considerable interest due to its great success in treating multiple cancers. Recently, there is also increasing interest in agents that can stimulate innate immune cell activities. Immune checkpoint inhibitors targeting innate immune cells can block inhibitory interactions ('don't eat me' signals) between tumor cells and phagocytes. CD47 is a transmembrane protein overexpressed in various cancers and acts as a potent 'do not eat me' signal that contributes to the immune evasion of cancer cells. Anti-CD47 peptides that can bind to CD47 and block CD47/SIRPα interaction were discovered using a novel phage display biopanning strategy. Anti-CD47 peptides enhanced the macrophage-mediated phagocytosis of NCI-H82 tumor cells in vitro . Unlike anti-CD47 antibodies, these peptides do not induce the agglutination of RBCs. Moreover, anti-CD47 peptides exhibit high specificity for MC-38 cancer cells expressing CD47. CMP-22 peptide showed the ability to increase the antitumor activity of doxorubicin and extends the survival of CT26 tumor-bearing mice. The discovered anti-CD47 peptides can be considered potential candidates for cancer immunotherapy by blocking the CD47/SIRPα interaction, especially in combination with chemotherapy, to elicit synergistic effects., Competing Interests: Conflict of interest disclosure statement: The authors declare no competing interests.

Piezoelectric polymers, particularly poly(vinylidene fluoride) (PVDF) and its copolymers attract attention from researchers due to their stretchability, flexibility, lightweight, and most importantly their biocompatible nature. In this research work, we report on the preparation of polymer composite films as flexible piezoelectric generators (PGs) and their electroactive phase (β- and γ-phase) formation. The piezoelectric properties of copolymer poly(vinylidene fluoride- co -hexafluoropropylene) (P(VDF-HFP)) have been enhanced by incorporating polyaniline (PANI) and methylammonium lead iodide (CH 3 NH 3 PbI 3 ) into it for a higher yield of the electroactive phases where a traditional electrical poling treatment was avoided. The remarkable enhancement in the piezoelectric phase ( i.e. , β-phase) of the P(VDF-HFP) copolymer has been reported in this work, and it is found that the overall improvement of the piezoelectric β-phase and the conversion of the degree of crystallinity is governed by the incorporation of the PANI and CH 3 NH 3 PbI 3 fillers as revealed by the attenuated total reflectance (ATR) and X-ray diffraction (XRD) analysis. The X-ray photoelectron spectroscopy (XPS) analysis further confirmed the interfacial dipole-dipole interaction of PANI with the P(VDF-HFP) copolymer matrix. Piezoelectric generators (PGs) fabricated from the composite films show an open circuit piezoelectric voltage output of 5 volts and an output power of 8.2 nW. The capacitor charging capability by simple repetitive finger touch and release motions (a pressure amplitude of ∼14 kPa) of the flexible PGs promises their applicability as a piezoelectric-based energy harvester where different mechanical vibrations can be utilized.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the coronavirus disease 2019 (COVID-19) pandemic, drastically modifies infected cells to optimize virus replication. One such modification is the activation of the host p38 mitogen-activated protein kinase (MAPK) pathway, which plays a major role in inflammatory cytokine production, a hallmark of severe COVID-19. We previously demonstrated that inhibition of p38/MAPK activity in SARS-CoV-2-infected cells reduced both cytokine production and viral replication. Here, we combined quantitative genetic screening, genomics, proteomics, and phosphoproteomics to better understand mechanisms underlying the dependence of SARS-CoV-2 on the p38 pathway. We found that p38β is a critical host factor for SARS-CoV-2 replication in multiple relevant cell lines and that it functions at a step after viral mRNA expression. We identified putative host and viral p38β substrates in the context of SARS-CoV-2 infection and found that most host substrates have intrinsic antiviral activities. Taken together, this study reveals a unique proviral function for p38β and supports exploring p38β inhibitor development as a strategy toward creating a new class of COVID-19 therapies. IMPORTANCE SARS-CoV-2 is the causative agent of the COVID-19 pandemic that has claimed millions of lives since its emergence in 2019. SARS-CoV-2 infection of human cells requires the activity of several cellular pathways for successful replication. One such pathway, the p38 MAPK pathway, is required for virus replication and disease pathogenesis. Here, we applied systems biology approaches to understand how MAPK pathways benefit SARS-CoV-2 replication to inform the development of novel COVID-19 drug therapies., Competing Interests: The authors declare no conflict of interest.

Background: The burden of mental health problems and inequalities in healthcare has emerged as critical issues, in Nepal. Strengthened citizen-driven social accountability (SA) is an effective strategy for building equitable health systems and providing quality healthcare services to all, yet SA in mental health is an under-researched area in Nepal., Objective: This study explores changes in mental health service delivery in the re-configured federal health system and discusses the functioning and effectiveness of SA in the federalized context of Nepal., Method: This case study research used a qualitative approach to data collection. We conducted Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs) with local stakeholders including people with experience of mental health problems. The audio-recorded interviews and discussions were transcribed and analyzed using a thematic content method., Results: A total of 49 participants were recruited, and 17 participated in interviews and 32 participated in six focus group discussions. From the data, eight themes emerged: Policy challenges in mental health, Governance and service delivery, Tokenism in the application of social accountability processes, Weak role of key actors in promoting accountability, Complaints and response, Discriminatory health and welfare system, Public attitudes and commitment towards mental health, and No differences experienced by the change to a federal system. It was found that existing health policies in Nepal inadequately cover mental health issues and needs. The prevailing laws and policies related to mental health were poorly implemented. There is a lack of clarity at different levels of government about the roles and responsibilities in the delivery of mental health services. Poor intra- and inter-governmental coordination, and delays in law-making processes negatively impacted on mental health service delivery. SA mechanisms such as social audits and public hearings exist within government health systems, however, application of these in mental health services was found poor. Rights-holders with mental health problems had not experienced any change in the provision of healthcare services for them even after the federalization., Conclusion: Mental health is insufficiently addressed by the health policies in Nepal, and SA mechanisms appeared to be rarely institutionalized to promote good governance and provide effective healthcare services to vulnerable populations. The provision of more equitable services and honest implementation of SA tools may foster greater accountability and thereby better service delivery for people with mental health problems., (© 2023. The Author(s).)

Objective: The aim of this research is to investigate the perspective of citizens of Nepal on the management COVID-19, the roll-out of the vaccine, and to gain an understanding of attitudes towards the governments' handling of the COVID-19 pandemic., Method: A qualitative methodology was used. In-depth interviews were conducted with 18 males and 23 females aged between 20 and 86 years old from one remote and one urban district of Nepal. Interviews were conducted in November and December 2021. A thematic approach was used to analyse the data, utilising NVivo 12 data management software., Result: Three major themes were identified: (1) Peoples' perspective on the management of COVID-19, (2) people's perception of the management of COVID-19 vaccination and (3) management and dissemination of information. It was found that most participants had heard of COVID-19 and its mitigation measures, however, the majority had limited understanding and knowledge about the disease. Most participants expressed their disappointment concerning poor testing, quarantine, vaccination campaigns and poor accountability from the government towards the management of COVID-19. Misinformation and stigma were reported as the major factors contributing to the spread of COVID-19. People's knowledge and understanding were mainly shaped by the quality of the information they received from various sources of communication and social media. This heavily influenced their response to the pandemic, the preventive measures they followed and their attitude towards vaccination., Conclusion: Our study concludes that the study participants' perception was that testing, quarantine centres and vaccination campaigns were poorly managed in both urban and rural settings in Nepal. Since people's knowledge and understanding of COVID-19 are heavily influenced by the quality of information they receive, we suggest providing contextualised correct information through a trusted channel regarding the pandemic, its preventive measures and vaccination. This study recommends that the government proactively involve grassroots-level volunteers like Female Community Health Volunteers to effectively prepare for future pandemics., Patient and Public Contribution: This study was based on in-depth interviews with 41 people from diverse socioeconomic backgrounds. This study would not have been possible without their participation., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Introduction: The monitoring and improvement of the health of labour migrants (LMs) require sufficient health data to be recorded and managed. In this context, this study was conducted to explore the management of health information of Nepalese labour migrants (NLMs)., Methods: This is an explorative qualitative study. Stakeholders involved directly or indirectly in maintaining the health profile of NLMs were first mapped, physically visited, and any documents or information were collected. Then, sixteen key informant interviews were conducted among these stakeholders related to labour migrants' health information management and challenges. A checklist extracted information from the interviews, and a thematic analysis was carried out to summarize the challenges., Results: Government agencies, non-governmental organizations, and government approved private medical centers are involved in generating and maintaining the health data of NLMs. The Foreign Employment Board (FEB) records deaths and disabilities of NLMs while at work abroad and these health records are also maintained in an online portal called Foreign Employment Information Management System (FEIMS) under the Department of Foreign Employment (DoFE). Health assessment of NLMs is a mandatory procedure before departure, which is done through the government-approved pre-departure private medical assessment centers. The health records from these assessment centers are first recorded in paper-based form and then entered into an online electronic form to be stored by the DoFE. The filled-up paper forms are sent to District Health Offices, which further report the data to the Department of Health Services (DoHS), Ministry of Health and Population (MoHP) and associated governmental infectious diseases centers. However, there is no formal health assessment of NLMs upon arrival to Nepal. Key informants raised various issues and concerns in maintaining health records of NLMs, which were grouped into three themes: lack of interest to develop a unified online system; need of competent human resources and equipment; and developing a set of health indicators for migrant health assessment., Conclusion: The FEB and government-approved private assessment centers are the main stakeholders in keeping the health records of outgoing NLMs. The current migrant health record keeping procedure in Nepal is fragmented. The national Health Information Management Systems does not effectively capture and categorize the health record of NLMs. There is a need to effectively link national health information system with premigration health assessment centers; and potentially develop a migrant health information management system by systematically keeping health records electronically with relevant health indicators on departing and arriving NLMs., (© 2023. The Author(s).)

Blockade of the interaction between programmed cell death ligand-1 (PD-L1) and its receptor PD-1 has shown great success in cancer immunotherapy. Peptides possess unique characteristics that give them significant advantages as immune checkpoint inhibitors. However, unfavorable physicochemical properties and proteolytic stability profiles limit the translation of bioactive peptides as therapeutic agents. Studies have revealed that cyclization improves the biological activity and stability of linear peptides. In this study, we report the use of macrocyclization scanning for the discovery of cyclic anti-PD-L1 peptides with improved bioactivity. The cyclic peptides demonstrated up to a 34-fold improvement in the PD-1/PD-L1 blocking activity and significant in vivo anti-tumor activity. Our results demonstrate that macrocyclization scanning is an effective way to improve the serum stability and bioactivity of the anti-PD-L1 linear peptide. This strategy can be employed in the optimization of other bioactive peptides, particularly those for protein-protein interaction modulation.

Labor migrants (LMs) often work in precarious work environments and are exposed to various health risks. There is a lack of information on the health of international Nepalese LMs (NLMs). This scoping study was conducted to assess the health problems of international NLMs based on the six-stage scoping review process of Arksey and O'Malley. A literature review and stakeholders consultation related to NLMs' health information were conducted. A total of 455 studies were identified of which 38 studies were potentially relevant based on title and/or abstract screening, and a total of 16 studies were finally included and assessed. The literature showed that the health problems incurred by NLMs are mainly mental health problems; accidents, injuries, and infectious diseases. The Foreign Employment Board is the main public stakeholder which records deaths and disabilities of NLMs. The record showed that there were a total of 3,752,811 labor permits approval, a total of 7467 deaths, and a total of 1512 disabilities among NLMs during the 11 years from 2008-2018. There is a need to have a better investigation of causes of death and disability among NLMs to assign scientific causes of death. Predeparture orientation on mental health coping strategies, labor rights, health-care accessibility options in destination countries, traffic safety, and infectious diseases should be instituted., Competing Interests: None

Viruses must effectively remodel host cellular pathways to replicate and evade immune defenses, and they must do so with limited genomic coding capacity. Targeting post-translational modification (PTM) pathways provides a mechanism by which viruses can broadly and rapidly transform a hostile host environment into a hospitable one. We use mass spectrometry-based proteomics to quantify changes in protein abundance and two PTM types-phosphorylation and ubiquitination-in response to HIV-1 infection with viruses harboring targeted deletions of a subset of HIV-1 genes. PTM analysis reveals a requirement for Aurora kinase activity in HIV-1 infection and identified putative substrates of a phosphatase that is degraded during infection. Finally, we demonstrate that the HIV-1 Vpr protein inhibits histone H1 ubiquitination, leading to defects in DNA repair., Competing Interests: Declaration of interests The Krogan Laboratory has received research support from Vir Biotechnology and F. Hoffmann-La Roche. N.J.K. has consulting agreements with the Icahn School of Medicine at Mount Sinai, Maze Therapeutics, and Interline Therapeutics, is a shareholder in Tenaya Therapeutics, Maze Therapeutics, and Interline Therapeutics, and is a financially compensated scientific advisory board member for GEn1E Lifesciences, Inc. A.M. is a compensated cofounder, a member of the board of directors, and a member of the scientific advisory boards of Spotlight Therapeutics and Arsenal Biosciences. A.M. is a cofounder, a member of the board of directors, and a member of the scientific advisory board of Survey Genomics. A.M. is a compensated member of the scientific advisory board of NewLimit. A.M. owns stock in Arsenal Biosciences, Spotlight Therapeutics, NewLimit, Survey Genomics, PACT Pharma, and Merck. A.M. has received fees from 23andMe, PACT Pharma, Juno Therapeutics, Trizell, Vertex, Merck, Amgen, Genentech, AlphaSights, Rupert Case Management, Bernstein, and ALDA. A.M. is an investor in and informal advisor to Offline Ventures and a client of EPIQ. The Marson lab has received research support from Juno Therapeutics, Epinomics, Sanofi, GlaxoSmithKline, Gilead, and Anthem., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To estimate utilization of maternal, perinatal healthcare services after the lockdown was implemented in response to the COVID-19 pandemic compared to the period before., Methods: This study conducted in Dakshinpuri, an urban neighborhood in Delhi, reports data over a 13-month period which includes the period "before lockdown" i.e., October 1, 2019 to March 21, 2020 and "after lockdown" i.e., March 22 to November 5, 2020. The period "after lockdown" included the lockdown phase (March 22 to May 31, 2020) and unlock phase (June 1 to November 5, 2020). Mothers delivered during this period in the study area were interviewed using semi-structured questionnaires. In-depth interviews (IDIs) were conducted in a subsample to understand the experiences, challenges, and factors for underutilization of healthcare services., Findings: The survey covered a total population of 21,025 in 4,762 households; 199 eligible mothers (mean age 27.4 years) were interviewed. In women who delivered after lockdown against before lockdown, adjusted odds of having >2 antenatal care visits in the third trimester was 80% lower (aOR 0.2, 95% CI 0.1-0.5); proportion of institutional deliveries was lower (93 vs. 97%); exclusive breastfeeding during first 6 months of birth (64.5 vs. 75.7%) and health worker home visitation within 6 weeks of birth (median, 1 vs. 3 visits) were substantially lower. Fear of contracting COVID-19, poor quality of services, lack of transportation and financial constraints were key issues faced by mothers in accessing health care. More than three-fourth (81%) of the mothers reported feeling down, depressed or hopeless after lockdown. The major factors for stress during lockdown was financial reasons (70%), followed by health-related concerns., Conclusion: COVID-19 pandemic-related lockdown substantially affected maternal and perinatal healthcare utilization and service delivery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sinha, Dudeja, Mazumder, Kumar, Adhikary, Roy, Rongsen Chandola, Mehta, Raina and Bhandari.)

Background: The impact of infertility on mental, emotional, physical and sexual health is grave, particularly in a pronatalist society. Literature is replete with evidence of wide ranging psychosocial consequences of infertility in women, indicating the need for identifying the gaps and designing appropriate context specific interventions to improve access and utilization of services. Data that are accessible, primarily from infertility clinics and women visiting hospitals for infertility treatment; information from community settings is rare. This is a protocol paper for a study to understand women's experiences and actions taken by them to cope with delayed conception., Methods: Mixed-methods cross-sectional design is used to obtain deep insights into the experiences of delayed conception, coping mechanisms, medical assistance and other help sought. Information is also being obtained on socio-demographic profile, fertility intentions, fertility quality of life, general medical history, obstetric, gynecological and sexual history, substance use and mental health status. A sample of 1530 women will be administered 4 modules of a quantitative survey. Focus group discussions, about four or till saturation point, will be conducted using purposive sampling. The study is recruiting from a population of women who previously participated in the 'Women and Infants Integrated Interventions for Growth Study (WINGS) and failed to conceive during 18 months follow up period. Data collected through questionnaire will be assembled, cleaned, analyzed and reported. The findings will be disseminated through reports with the ethics review committee, government entities, academic and research publications., Discussion: This study will provide insights on the experiences and coping strategies of women with delayed conception in the study community. Results will assist in designing appropriate interventions to meet the holistic health and psychosocial needs of women with delayed conception and promote sexual and reproductive health within the broader framework of Sustainable Development Goals and Universal health coverage., Trial Registration: Trial registration number: CTRI/2020/03/023955., Competing Interests: The authors have declared that no competing interests exist.

Physiological monitoring sensors have been critical in diagnosing and improving the healthcare industry over the past 30 years, despite various limitations regarding providing differences in signal outputs in response to the changes in the user's body. Four-dimensional (4D) printing has been established in less than a decade; therefore, it currently offers limited resources and knowledge. Still, the technique paves the way for novel platforms in today's ever-growing technologies. This innovative paradigm of 4D printing physiological monitoring sensors aspires to provide real-time and continuous diagnoses. In this perspective, we cover the advancements currently available in the 4D printing industry that has arisen in the last septennium, focusing on the overview of 4D printing, its history, and both wearable and implantable physiological sensing solutions. Finally, we explore the current challenges faced in this field, translational research, and its future prospects. All of these aims highlight key areas of attention that can be applied by future researchers to fully transform 4D printed physiological monitoring sensors into more viable medical products., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Exploration published by Henan University and John Wiley & Sons Australia, Ltd.)

Background: Postpartum family planning (PPFP) helps women space childbirths, increase exclusive breastfeeding and prevent unintended pregnancies, leading to reduction in maternal, infant and child morbidities and mortality. Unmet need of family planning is highest among women in the postpartum period due to lack of knowledge, cultural and religious barriers, access barriers and low antenatal care service utilization. However, in spite of low prevalence of postpartum family planning practices, birth-to-birth interval is reportedly high in Delhi, India. This study explores the postpartum contraception practices and the relationship between use of postpartum contraception and subsequent child linear growth., Methods: This is a mixed method cohort study on PPFP and is nested within an ongoing "Women and Infants Integrated Interventions for Growth Study" (WINGS). Married women aged 18-30 years who have delivered a live baby are recruited for quantitative interviews at 6 weeks, 6, 12, and 24 months postpartum. In-depth interviews are conducted with a randomly selected sub-sample of women at each of the four time points, 35 husbands and 20 local service providers to understand their perspectives on PPFP practices., Discussion: The findings from the study will provide useful insights into couples' contraception preferences and choice of contraception, modern and traditional, initiation time and the effect of birth spacing and contraception use on subsequent linear growth of the child. This knowledge will be of significant public health relevance and will help in designing appropriate interventions for appropriate postpartum contraception use and delivery strategies. The study aims to work address the Sexual and Reproductive Health and Rights goal of promoting reproductive health, voluntary and safe sexual and reproductive choices for women., Trial Registration: Trial registration number: CTRI/2020/03/023954 ., (© 2021. The Author(s).)

Herein we have reported for the first time a one-pot, one step methodology to synthesize isomeric polythiophene (IPTh) possessing 2,2, 2,4 and 5,4 linkages. The method of polymerization of thiophene to IPTh involved reacting thiophene with DDQ in the presence of concentrated H 2 SO 4 at 40 °C and the polymerization is completed in 10 minutes. The synthesized IPTh was characterized by various spectroscopic and microscopic techniques. The formation of polaron and bipolaron in an iodine doped sample (IPTh-I 2 ) has been confirmed by IR, Raman and UV-Vis spectra. The electrical conductivity of the synthesized IPTh and IPTh-I 2 have been studied by impedance spectroscopy and found to be ∼10 -5 and 10 -3 S cm -1 respectively. IPTh exhibits an excellent thermal stability up to 150 °C, and low optical band gap of 3.49 eV suitable for photovoltaic applications. The weight average molecular weight of IPTh has been found to be 18.636 kDa, and it has a better post functionalization capability and hence wider scope than polythiophene (PTh).

Immune checkpoint blockade has shown unprecedented and durable clinical response in a wide range of cancers. T cell immunoglobulin and mucin domain 3 (TIM3) is an inhibitory checkpoint protein that is highly expressed in tumor-infiltrating lymphocytes. In various cancers, the interaction of TIM3 and Galectin 9 (Gal9) suppresses anti-tumor immunity mediated by innate as well as adaptive immune cells. Thus, the blockade of the TIM3/Gal9 interaction is a promising therapeutic approach for cancer therapy. In addition, co-blockade of the TIM3/Gal9 pathway along with the PD-1/PD-L1 pathway increases the therapeutic efficacy by overcoming non-redundant immune resistance induced by each checkpoint. Here, we summarize the physiological roles of the TIM3/Gal9 pathway in adaptive and innate immune systems. We highlight the recent clinical and preclinical studies showing the involvement of the TIM3/Gal9 pathway in various solid and blood cancers. In addition, we discuss the potential of using TIM3 and Gal9 as prognostic and predictive biomarkers in different cancers. An in-depth mechanistic understanding of the blockade of the TIM3/Gal9 signaling pathway in cancer could help in identifying patients who respond to this therapy as well as designing combination therapies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: In response to the COVID-19 pandemic, incoming travelers were quarantined at specific centers in Nepal and major checkpoints in Nepal-India border. Nepal adopted a generic public health approaches to control and quarantine returnee migrants, with little attention towards the quality of quarantine facilities and its aftermath, such as the poor mental health of the returnee migrants. The main objective of this study was to explore the status of anxiety and depression, and factors affecting them among returnee migrants living in institutional quarantine centers of western Nepal., Methods: A mixed method approach in this study included a quantitative survey and in-depth interviews (IDIs) among respondents in quarantine centers of Karnali province between 21st April and 15th May 2020. Survey questionnaire utilized Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) tools, which were administered among 441 quarantined returnee migrants. IDIs were conducted among 12 participants which included a mix of six quarantined migrants and healthcare workers each from the quarantine centres. Descriptive and inferential analyses were conducted on quantitative data; and thematic analysis was utilized for qualitative data., Results: Mild depression (9.1%; 40/441) and anxiety (16.1%; 71/441) was common among respondents followed by moderate depression and anxiety {depression (3.4%; 15/441), anxiety (4.1%; 18/441)} and severe depression and anxiety {depression (1.1%; 5/441), anxiety (0.7%; 3/441)}. Anxiety and depression were independent of their socio-demographic characteristics. Perceived fear of contracting COVID-19, severity and death were prominent among the respondents. Respondents experienced stigma and discrimination in addition to being at the risk of disease and possible loss of employment and financial responsibilities. In addition, poor (quality and access to) health services, and poor living condition at the quarantine centres adversely affected respondents' mental health., Conclusion: Depression and anxiety were high among quarantined population and warrants more research. Institutional quarantine centers of Karnali province of Nepal were in poor conditions which adversely impacted mental health of the respondents. Poor resource allocation for health, hygiene and living conditions can be counterproductive to the population quarantined., Competing Interests: All authors declare that they have no competing interests.

COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which infects host cells by binding its viral spike protein receptor-binding domain (RBD) to the angiotensin converting enzyme 2 (ACE2) on host cells. Blocking the SARS-CoV-2-RBD/ACE2 interaction is, therefore, a potential strategy to inhibit viral infections. Using a novel biopanning strategy, a small anti-ACE2 peptide is discovered, which shows high affinity and specificity to human ACE2. It blocks not only the SARS-CoV-2-RBD/ACE2 interaction but also the SARS-CoV-1-RBD/ACE2 interaction. Moreover, it inhibits SARS-CoV-2 infection in Vero-E6 cells. The peptide shows negligible cytotoxicity in Vero-E6 cells and Huh7 cells. In vivo short-term lung toxicity study also demonstrates a good safety of the peptide after intratracheal administration. The anti-ACE2 peptide can be potentially used as a prophylactic or therapeutic agent for SARS-CoV-2 or other ACE2-mediated viruses. The strategy used in this study also provides a fast-track platform to discover other antiviral peptides, which will prepare the world for future pandemics., (© 2021 Wiley‐VCH GmbH.)

Liver fibrosis is the excessive accumulation of extracellular matrix due to chronic injuries, such as viral infection, alcohol abuse, high-fat diet, and toxins. Liver fibrosis is reversible before it progresses to cirrhosis and hepatocellular carcinoma. Type 2 diabetes significantly increases the risk of developing various complications including liver diseases. Abundant evidence suggests that type 2 diabetes and liver diseases are bidirectionally associated. Patients with type 2 diabetes experience more severe symptoms and accelerated progression of live diseases. Obesity and insulin resistance resulting from hyperlipidemia and hyperglycemia are regarded as the two major risk factors that link type 2 diabetes and liver fibrosis. This review summarizes possible mechanisms of the association between type 2 diabetes and liver fibrosis. The cellular protein markers that can be used for diagnosis and therapy of type 2 diabetes-associated liver fibrosis are discussed. We also highlight the potential therapeutic agents and their delivery systems that have been investigated for type 2 diabetes-associated liver fibrosis., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Immunization acts as a key intervention to reduce under-five mortality and morbidity. Despite global progress on vaccination, difficulties in the utilization of this service in developing countries have been observed. According to Nepal Demographic and Health Survey (NDHS) 2016, only 78% of children received a complete dose of vaccine among which the first-dose receiver of DPT is 98%, whereas only 83% received a third dose. This study aims to explore the influencing factors of DPT vaccination dropout in Nepal., Methods: The explorative study was done through secondary data analysis of NDHS 2016. The KR file was used for the analysis of information for 2883 children. Factors influencing dropout of DPT vaccination were explored against the independent variables such as external environment, predisposing factors, and enabling resources. All the analyses were weighted before the analysis. The descriptive, bivariate, and multivariate analyses were performed. The variables showing collinearity have been removed in the final model., Results: A higher dropout was reported in Terai (18.9%) and province 2 (22.0%), among uneducated mothers (18.1%) and uneducated fathers (19.4%), less than once a week internet users (22.2%), the nonradio listener (17.4%), who had <4 ANC visits (22.7%), home delivery (19.2%), no advised SBA (19.1%), long distance to health facility (17.9%), no iron supplementation in pregnancy (24.3%), and PNC by TBA/others (21.1%). All these tested relationships were found statistically significant ( P value <0.05). The aOR for dropout was found to be 7.94 (4.07-15.51) for mothers with less than 4 or no ANC visit, long distance to health facility 4.68 (1.98-10.67), province 2 3.53 (1.13-11.03), and mother without formal employment 2.33 (1.52-3.55)., Conclusion: Factors related to health services, distance, provinces, and socioeconomic status of the family were influencers for vaccine dropout. Targeted intervention towards disadvantaged regions, counseling the mother during ANC, improving the education status of parents, access to the health facility, and use of mass media for advocacy are hereby recommended., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Kanchan Thapa et al.)

Background: The COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID-19 symptoms., Methods: A cross-sectional survey was conducted between May-June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables., Results: The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31-9.06), while stress (OR 4.27, 95% CI 1.09-18.32) and depressive symptoms (OR 3.11, 95% CI 1.05-9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83-6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05-8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03-11.46)., Conclusion: The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes., Competing Interests: The authors have declared that no competing interests exist.

Background: The COVID-19 pandemic has created a global health emergency requiring an effective public health response including citizen's roles in preventing spread and controlling the pandemic. Little is known about public knowledge, beliefs and behaviors in-relation to the pandemic in Nepal. This study aims to assess knowledge, attitude and practices (KAP) toward COVID-19 among the general public and to identify associated factors. Methods: A cross-sectional survey was conducted between May-June 2020 with a sample of 645, recruited from 26 hospitals across Nepal. We conducted telephone interviews using a semi-structured questionnaire related to KAP regarding COVID-19. T -test and one-way ANOVA was conducted to determine group differences for socio-demographic variables. Linear regression and correlational analysis were performed to identify associated factors and measure strength and direction of relationships. Results: Overall mean scores for knowledge, attitude and practice were 11.6 (SD 4.5), 2.7 (SD 1.8), and 9.9 (SD 1.93) respectively, but differed by socio-demographic characteristics. Positive but weak linear correlations were observed between knowledge-practice ( r = 0.19, p < 0.01) and attitude-practice ( r = 0.08, p < 0.05). The relationship between knowledge and education was fairly strong ( r = 0.34, p < 0.01). Province, place of residence, ecological area, age, gender and caste/ethnicity were also significantly associated with KAP score of participants. Conclusion: The study found varying degrees of correlation between Knowledge, Attitude and Practice that may increase as the pandemic evolves in Nepal. Knowledge and level of education had positive associations with attitude and adherence to precautionary measures. The findings suggest a need for targeted community awareness interventions for the most vulnerable populations, men, those with no school education, the elderly and people living in rural areas., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Devkota, Sijali, Bogati, Clarke, Adhikary and Karkee.)

Purpose : Pancreatic ductal adenocarcinoma (PDAC) has the lowest five-year survival rate of all cancers in the United States. Programmed death 1 receptor (PD-1)-programmed death ligand 1 (PD-L1) immune checkpoint inhibition has been unsuccessful in clinical trials. Myeloid-derived suppressor cells (MDSCs) are known to block anti-tumor CD8+ T cell immune responses in various cancers including pancreas. This has led us to our objective that was to develop a clinically relevant in vitro organoid model to specifically target mechanisms that deplete MDSCs as a therapeutic strategy for PDAC. Method : Murine and human pancreatic ductal adenocarcinoma (PDAC) autologous organoid/immune cell co-cultures were used to test whether PDAC can be effectively treated with combinatorial therapy involving PD-1 inhibition and MDSC depletion. Results : Murine in vivo orthotopic and in vitro organoid/immune cell co-culture models demonstrated that polymorphonuclear (PMN)-MDSCs promoted tumor growth and suppressed cytotoxic T lymphocyte (CTL) proliferation, leading to diminished efficacy of checkpoint inhibition. Mouse- and human-derived organoid/immune cell co-cultures revealed that PD-L1-expressing organoids were unresponsive to nivolumab in vitro in the presence of PMN-MDSCs. Depletion of arginase 1-expressing PMN-MDSCs within these co-cultures rendered the organoids susceptible to anti-PD-1/PD-L1-induced cancer cell death. Conclusions : Here we use mouse- and human-derived autologous pancreatic cancer organoid/immune cell co-cultures to demonstrate that elevated infiltration of polymorphonuclear (PMN)-MDSCs within the PDAC tumor microenvironment inhibit T cell effector function, regardless of PD-1/PD-L1 inhibition. We present a pre-clinical model that may predict the efficacy of targeted therapies to improve the outcome of patients with this aggressive and otherwise unpredictable malignancy.

Background: Poor mental health and illness among the working population have serious socioeconomic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali male returnee-migrants and non-migrant workers, and their perceptions about risk factors for poor health and health service accessibility., Methods: This qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions comprising 25 men and a total of 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically., Result: Migrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours' hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers' poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers' poor mental health., Conclusion: Both migrant and non-migrant workers experienced poor mental and physical health, largely affected by their adverse living and working conditions, unmet familial and financial needs and unhealthy life styles. Greater compliance is needed by employers of work agreements and the promotion of labor rights for worker's health and safety. In addition, policy interventions to raise awareness about occupational health risks and effective safety training for all workers (migrant and non-migrant) are recommended., Competing Interests: The authors declare that they have no competing interests., (© 2020 The Author(s).)

The pathogenesis of gestational diabetes mellitus (GDM) is multifactorial and it shares many features with type 2 diabetes mellitus. Growth differentiation factor 15 (GDF-15), a member of transforming growth factor-β superfamily, is expressed in a high amount in the placenta in addition to other organs. This cross-sectional study was performed to assess the difference of GDF-15 and pro-inflammatory cytokines between pregnant women with or without GDM, and to explore the possible association of GDF-15 with the parameters of dysglycemia (Serum insulin, HOMA-IR, fasting, 60 min, and 120 min post-75 gm oral glucose plasma glucose levels) and inflammation (IL-6 and TNF-α) in women with GDM at 24-28 weeks of gestation. Thirty-five women with GDM and 30 age-matched non-diabetic pregnant control (NDPC) subjects were recruited for the study. Mean serum GDF-15, IL-6, and TNF-α levels were significantly higher in GDM in comparison to the NDPC population. These differences persisted even after adjusting for the possible confounders like maternal age and BMI. GDF-15 level showed a positive correlation with parameters of dysglycemia (Serum insulin, HOMA-IR, fasting, 60 min, and 120 min post-75 gm oral glucose plasma glucose levels) but a variable correlation with the markers of inflammation. In conclusion, our study provides evidence that, in Indian women, serum GDF-15 level is higher in GDM in comparison to age-matched pregnant subjects without GDM in the early third trimester pregnancy. Moreover, in third trimester, GDF-15 level increases with increase in plasma glucose and insulin resistance., Competing Interests: Conflict of interestThe authors declare that there was no potential conflict of interest., (© The Japan Diabetes Society 2020.)

Background: Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India., Methods: Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. A further 12 stakeholders working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data were analysed thematically., Results: The interviewed returnee migrants worked in 15 of India's 29 states, most as daily-wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services., Conclusions: Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to.

Every year around 1000 Nepali migrant workers die abroad. Every one in three females and one in ten males commit suicide, reflecting a high mental health risk among Nepali migrant workers. This study aims to identify triggers of mental ill-health among Nepali migrant workers and their perceptions on the need of mental health components in the pre-departure orientation programme. We conducted five focus group discussions (FGD) and seven in-depth interviews with Nepali migrant workers and eight semi-structured interviews with stakeholders working for migrants. Participants were invited at Kathmandu's international airport on return from abroad, at hotels or bus stations near the airport, through organisations working for migrants, and participants' network. All FGD and interviews were conducted in Kathmandu and audio recorded, transcribed and translated into English. Data were analyzed thematically. High expectations from families back home, an unfair treatment at work, poor arrangements of accommodation, loneliness and poor social life abroad were frequently reported factors for poor mental health. Access to mental health services abroad by Nepali migrant was also poor. We found little on mental health in the pre-departure orientation. We need to improve our knowledge of mental health risks to provide better, more focused and more up-to-date pre-departure training to new migrant workers leaving Nepal.

Recent studies have revealed that tissue macrophages are derived from yolk sac precursors or fetal liver monocytes, in addition to bone marrow monocytes. The relative contribution of these cells to the tissue macrophage pool is not fully understood, but embryo-derived cells are supposed to be more important because of their capacity to self-renew. Here, we show the presence of adult bone marrow-derived macrophages that retain self-renewing capacity. The self-renewing macrophages were readily obtained by long-term culture of mouse bone marrow cells with macrophage colony-stimulating factor (M-CSF), a key cytokine for macrophage development. They were non-tumorigenic and proliferated in the presence of M-CSF in unlimited numbers. Despite several differences from non-proliferating macrophages, they retained many features of cells of the monocytic lineage, including the differentiation into dendritic cells or osteoclasts. Among the transcription factors involved in the self-renewal of embryonic stem cells, Krüppel-like factor 2 (KLF2) was strongly upregulated upon M-CSF stimulation in the self-renewing macrophages, which was accompanied by the downregulation of MafB, a transcription factor that suppresses KLF2 expression. Indeed, knockdown of KLF2 led to cell cycle arrest and diminished cell proliferation in the self-renewing macrophages. Our new cell model would be useful to unravel differences in phenotype, function, and molecular mechanism of proliferation among self-renewing macrophages with different origins., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s) 2020.)

With growing interest in quantum technologies, possibilities of synchronizing quantum systems have garnered significant recent attention. In experiments with dilute ensemble of laser cooled spin-1 ^{87}Rb atoms, we observe phase difference of spin coherences to synchronize with phases of external classical fields. An initial limit-cycle state of a spin-1 atom localizes in phase space due to dark-state polaritons generated by classical two-photon tone fields. In particular, when the two couplings fields are out of phase, the limit-cycle state synchronizes only with two artificially engineered, anisotropic decay rates. Furthermore, we observe a blockade of synchronization due to quantum interference and emergence of Arnold-tongue-like features. Such anisotropic decay induced synchronization of spin-1 systems with no classical analog can provide insights in open quantum systems and find applications in synchronized quantum networks.

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor-Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Background: Since Nepali cross-border migrants can freely enter, work and stay in India, they are largely undocumented. The majority is involved in semi-skilled or unskilled jobs with limited labour rights and social security, a fact which predisposes them to psychological distress. We aimed to assess the prevalence of and factors associated with psychological morbidity among Nepali migrants upon their return from India., Methods: A community based cross-sectional study was conducted in six districts of Nepal between September 2017 and February 2018. A total of 751 participants who had worked at least six months in India and returned to Nepal were interviewed from 24 randomly selected clusters. The General Health Questionnaire (GHQ)-12 was used to measure the psychological morbidity. Data were analysed using Poisson regression analysis., Results: The majority was younger than 35 years (64.1%), male (96.7%), married (81.8%), had at least a primary education (66.6%), and belonged to Dalit, Janajati and religious minorities (53.7%). The prevalence of psychological morbidity was 13.5% (CI: 11.2-16.1%). Participants aged 45 years and above (adjusted prevalence ratio (aPR) = 2.74), from the Terai (aPR = 3.29), a religious minority (aPR = 3.64), who received no sick leave (aPR = 2.4), with existing health problems (aPR = 2.0) and having difficulty in accessing health care (aPR = 1.88) were more likely than others to exhibit a psychological morbidity., Conclusion: This study demonstrated that psychological morbidity was prevalent in the study participants and varied significantly with individual characteristics, work conditions and health. Multifaceted approaches including psychological counselling for returnees and protection of labour and health rights in the workplace are recommended to help reduce psychological morbidity.

There are many Nepali men working in the Middle East and Malaysia and media reports and anecdotal evidence suggest a high risk of workplace-related accidents and injuries for male Nepali workers. Therefore, this study aims to explore the personal experiences of male Nepali migrants of unintentional injuries at their place of work. In-depth, face-to-face interviews (n = 20) were conducted with male Nepali migrant workers. Study participants were approached at Kathmandu International Airport, hotels and lodges around the airport. Interviews were transcribed and analysed using thematic analysis. Almost half of study participants experienced work-related accident abroad. The participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries. Nepali migrant workers would appear to be at a high risk of workplace unintentional injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing existing policies, introduce better legislation where necessary, ensure universal health (insurance) coverage for labour migrants, and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers.

Accurate assessment of deep percolation (potential groundwater recharge) under different field crops is essential for sustainable management of scarce water resources and proper planning of crop rotation in irrigated, semi-arid regions of the world. The potential recharge from commonly grown field crops in semi-arid Indo-Gangetic Plain (IGP) of India was estimated using HYDRUS-1D model, where, irrigation, evapotranspiration, and soil moisture dynamics were simulated. Simultaneously, net groundwater use by different cropping patterns was also calculated. Among the hydraulic parameters, n was found most sensitive for water percolation. During rainy season, 293.8 and 159.1 mm water was percolated below the root zone of cotton and soybean, respectively, which accounted for 39.4 and 32.9% of the water input. During winter season, 66.8 and 30.3 mm water was percolated below the root zone of winter maize and mustard, respectively, accounting for 20.5 and 10.6% of added water. It was observed that net groundwater use was positive for cotton, soybean, and summer maize with the values of 168.8, 159.1, and 18.0 mm year -1 , respectively, and negative for rice, wheat, winter maize, and mustard. For the eight most important cropping patterns of semi-arid IGP, the net groundwater use was negative and varied between - 4.4 mm year -1 for cotton-maize and -423 mm year -1 for rice-wheat. With these cropping patterns, the overall rate of decline of groundwater was 231 mm year -1 . It was found that maize-wheat and soybean-wheat cropping patterns consume much less water than rice-wheat cropping pattern and therefore are suitable to arrest the declining trend of groundwater in semi-arid IGP of India.

The type II Dirac semimetal PdTe[Formula: see text] is unique in the family of topological parent materials because it displays a superconducting ground state below 1.7 K. Despite wide speculation on the possibility of an unconventional topological superconducting phase, tunneling and heat capacity measurements revealed that the superconducting phase of PdTe[Formula: see text] follows predictions of the microscopic theory of Bardeen, Cooper and Schrieffer for conventional superconductors. The superconducting phase in PdTe[Formula: see text] is further interesting because it also displays properties that are characteristic of type-I superconductors and are generally unexpected for binary compounds. Here, from scanning tunneling spectroscopic measurements we show that the surface of PdTe[Formula: see text] displays intrinsic electronic inhomogeneities in the normal state which leads to a mixed type I and type II superconducting behaviour along with a spatial distribution of critical fields in the superconducting state. Understanding of the origin of such inhomogeneities may be important for understanding the topological properties of PdTe[Formula: see text] in the normal state.

The present article reports the application of β-cyclodextrin grafted polyacrylamides synthesized through solution and microwave assisted polymerization techniques as flocculants and then the employment of partially hydrolyzed products of best grade of each technique in-vitro drug release study of diclofenac sodium. Five different grades of β-cyclodextrin grafted polyacrylamides by each of solution and microwave assisted polymerization techniques have been synthesized, by varying the monomer concentration. The synthesized polymers have been well characterized and their flocculation performances have been evaluated in kaolin suspension through settling and jar test methods Then the best performing grades of both the techniques have been partially hydrolyzed to prepare three different grades each technique by varying the concentration aqueous NaOH solution. Flocculation efficiencies of these polymers have been investigated in kaolin suspension. Thus best grades of partially hydrolyzed grafted polymers of each technique have been chosen for further study of drug delivery. In-vitro drug release study has been done using diclofenac sodium loaded microbeads prepared by ionic gelation method with two partially hydrolyzed grafted polymers (one from each technique) in phosphate buffer solution (PBS) at 37±0.5 ○ C and pH 7.4. The drug load and release have been analyzed by UV-vis spectroscopy., (Copyright © 2017 Elsevier B.V. All rights reserved.)

We have prepared a flexible polymer composite film containing poly(vinylidene fluoride-co-hexafluoropropylene) (P(VDF-HFP)) and Zn 2+ for the fabrication of a multifunctional piezoelectric based nanogenerator (MFNG), where a traditional electrical poling treatment was avoided. The desirable amount of Zn 2+ yields more than 99% of electro-active phases in the P(VDF-HFP) matrix that co-operates to enhance the dielectric properties of the composite film via hydrogen bonding interactions. In situ thermal Fourier transform infrared (FT-IR) spectroscopy affirms the improved thermal stability of the electro-active β-phase and the β→γ phase transition temperature in the Zn 2+ doped composite film. It also shows UV absorption and intense blue light emission confirmed by a CIE 1931 chart that gives it applicability as a flexible optical sensor. The MFNG behaves as an efficient mechanical energy harvester that delivers an open-circuit voltage ∼6 V and an output power of 2.4 μW and successfully enables the charging of a capacitor by simple repetitive finger touch and release motions (a pressure amplitude of ∼14 kPa). The UV light sensing ability of the MFNG is confirmed under the continuous application and removal of applied stress, which is very promising for designing versatile self-powered optoelectronic smart sensors. Our approach is very simple and cost effective for the construction of a new class of flexible multifunctional energy harvesters that have wonderful applications in the areas of piezo-photonics, wireless detection and flexible self-powered opto-electronics.

Composite nanofibers of Eu 3+ doped poly(vinylidene fluoride-co-hexafluoropropylene) (P(VDF-HFP))/graphene are prepared by the electrospinning technique for the fabrication of ultrasensitive wearable piezoelectric nanogenerators (WPNGs) where the post-poling technique is not necessary. It is found that the complete conversion of the piezoelectric β-phase and the improvement of the degree of crystallinity is governed by the incorporation of Eu 3+ and graphene sheets into P(VDF-HFP) nanofibers. The flexible nanocomposite fibers are associated with a hypersensitive electronic transition that results in an intense red light emission, and WPNGs also have the capability of detecting external pressure as low as ~23 Pa with a higher degree of acoustic sensitivity, ~11 V Pa -1 , than has ever been previously reported. This means that ultrasensitive WPNGs can be utilized to recognize human voices, which suggests they could be a potential tool in the biomedical and national security sectors. The capacitor's ability to charge from abundant environmental vibrations, such as music, wind, body motion, etc, drives WPNGs as a power source for portable electronics. This fact may open up the prospect of using the Eu 3+ doped P(VDF-HFP)/graphene composite electrospun nanofibers, with their multifunctional properties such as vibration sensitivity, wearability, red light emission capability and piezoelectric energy harvesting, for various promising applications in portable electronics, health care monitoring, noise detection and security monitoring.

Approximately 3.5 million Nepalese are working as migrant workers in the Gulf countries, Malaysia, and India. Every year there are more than 1000 deaths and many hundreds cases of injuries among Nepalese workers in these countries excluding India. A postmortem examination of migrant workers is not carried out in most of these countries, and those with work-related injuries are often sent back to home. Uninsured migrant workers also do not have easy access to health care services in host countries due to the high medical and hospital fees. Greater efforts are needed to protect the health and well-being, labor rights, and human rights of migrant workers from Nepal and other South-Asian nations. There is a need to enforce universal labor laws in these countries and to develop accurate records of mortality and morbidity and their causes., (© 2016 APJPH.)

To evaluate the biophysical stability of protein against oxidative stress, hydrogen peroxide (H2O2) was used to induce non-site-specific protein oxidation. Various biophysical methods were utilized including RP-HPLC, DSC, DLS, and CD. Lysozyme was chosen as a model protein and three different antioxidants (ascorbic acid, N-acetyl-l-cysteine, and l-methionine) were selected to observe their effect. Significant increase in hydrodynamic size, decrease in α-helix propensity, and increase in β-sheet content evident with increasing H2O2 concentration and temperature suggested methionine residues as the most probable site of oxidation. Among the three anti-oxidants, methionine proved superior in suppressing protein oxidation with its increasing concentration. Methionine reacted with H2O2 to form methionine sulfoxide, which aided in decreasing the oxidant concentration to react with the protein. The hydrodynamic size of methionine containing protein was retained when incubated at 40°C after 14 days with unchanged transition temperature (Tm). In contrast, RP-HPLC revealed oxidation alterations when the same samples were stored at 40°C, highlighting the significant impact of temperature on kinetics. N-acetyl-l-cysteine and ascorbic acid were relatively less protective. Their hydrodynamic size was increased with decreasing Tm compared to the reference. In summary, methionine was a superior antioxidant, implicating a promising component in the protein formulation for suppressing oxidation., (Copyright © 2015 Elsevier B.V. All rights reserved.)