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This special issue focuses on natural hazards and risks in the Himalayan region. Nine research articles address critical gaps in research, from compiling avalanche databases to developing early warning systems for landslides and assessing flood risk and vulnerabilities in urban areas. By fostering interdisciplinary collaboration and leveraging advanced methods, the research presented in this special issue contributes to building safer and more resilient communities in the Himalayan region. [ABSTRACT FROM AUTHOR]

Byline: Deepak. Daunaria, Girish. Singh, Ankit. Agarwal, Priyanka. Mishra Dear Editor, We report a case of COVID-19-associated acute respiratory distress syndrome (C-ARDS) in a 57-year-old woman, hospitalized for 43 days [...]

Microgrids are an increasingly common component of the evolving electricity grids with the potential to improve local reliability, reduce costs, and increase penetration rates for distributed renewable generation. The additional complexity of microgrids often leads to increased investment costs, creating a barrier for widespread adoption. These costs may result directly from specific needs for islanding detection, protection systems and power quality assurance that would otherwise be avoided in simpler system configurations. However, microgrids also facilitate additional value streams that may make up for their increased costs and improve the economic viability of microgrid deployment. This paper analyses the literature currently available on research relevant to value streams occurring in microgrids that may contribute to offset the increased investment costs. A review on research related to specific microgrid requirements is also presented.

Silver is a widely used antimicrobial agent, yet, when impregnated in macroscopic dressings, it stains wounds, can lead to tissue toxicity, and can inhibit healing. Recently, polymeric nanofilms containing silver nanoparticles were reported to exhibit antimicrobial activity at loadings and release rates of silver that are 100× lower than conventional dressings. Here, fabrication of composite microfilm constructs that provide a facile way to transfer the silver-loaded polymeric nanofilms onto wounds in vivo is reported. The construct is fabricated from a silver nanoparticle-loaded polymeric nanofilm that is laminated with a micrometer-thick-soluble film of polyvinylalcohol (PVA). When placed on a moist wound, the PVA dissolves, leaving the silver-loaded nanofilm immobilized on the wound-bed. In vitro, the immobilized nanofilms release

Silver is a commonly used topical antimicrobial. However, technologies to immobilize silver at the wound surface are lacking, while currently available silver-containing wound dressings release excess silver that can be cytotoxic and impair wound healing. We have shown that precise concentrations of silver at lower levels can be immobilized into a wound bed using a polyelectrolyte multilayer attachment technology. These silver nanoparticle-impregnated polyelectrolyte multilayers are noncytotoxic yet bactericidal in vitro, but their effect on wound healing in vivo was previously unknown. The purpose of this study was to determine the effect on wound healing of integrating silver nanoparticle/polyelectrolyte multilayers into the wound bed. A full-thickness, splinted, excisional murine wound healing model was employed in both phenotypically normal mice and spontaneously diabetic mice (healing impaired model). Gross image measurements showed an initial small lag in healing in the silver-treated wounds in diabetic mice, but no difference in time to complete wound closure in either normal or diabetic mice. Histological analysis showed modest differences between silver-treated and control groups on day 9, but no difference between groups at the time of wound closure. We conclude that silver nanoparticle/polyelectrolyte multilayers can be safely integrated into the wound beds of both normal and diabetic mice without delaying wound closure, and with transient histological effects. The results of this study suggest the feasibility of this technology for use as a platform to affect nanoscale wound engineering approaches to microbial prophylaxis or to augment wound healing.

Health-care settings have an important responsibility toward environmental health and safety. The operating room is a major source of environmental pollution within a hospital. Inhalational agents and nitrous oxide are the commonly used gases during general anesthesia for surgeries, especially in the developing world. These greenhouse gases contribute adversely to the environmental health both inside the operating room and in the outside atmosphere. Impact of these anesthetic agents depends on the total consumption, characteristics of individual agents, and gas flows, with higher levels increasing the environmental adverse effects. The inimical impact of nitrous oxide is higher due to its longer atmospheric half-life and potential for destruction of the ozone layer. Anesthesiologist of today has a choice in the selection of anesthetic agents. Prudent decisions will help in mitigating environmental pollution and contributing positively to a greener planet. Therefore, a shift from inhalational to intravenous-based technique will reduce the carbon footprint of anesthetic agents and their impact on global climate. Propofol forms the mainstay of intravenous anesthesia technique and is a proven drug for anesthetic induction and maintenance. Anesthesiologists should appreciate growing concerns about the role of inhalational anesthetics on the environment and join the cause of environmental responsibility. In this narrative review, we revisit the pharmacological and pharmacokinetic considerations, clinical uses, and discuss the merits of propofol-based intravenous anesthesia over inhalational anesthesia in terms of environmental effects. Increased awareness about the environmental impact and adoption of newer, versatile, and user-friendly modalities of intravenous anesthesia administration will pave the way for greener anesthesia practice. [ABSTRACT FROM AUTHOR]

Background: Acromioclavicular joint dislocations accounts for about 12% of shoulder girdle injuries. However, there is no gold standard procedure for surgical treatment of acute high-grade AC joint injury. Recently, the endobutton technique has been elucidated for the treatment of AC-joint dislocation. Hence, we employed this technique and analyzed its outcome. Material & Method: 24 patients aged between 20-65 years with acute Type III-VI AC joint dislocation were included in the study. Radiograph of both clavicle anteroposterior (AP) stress view was obtained to diagnose. All patients were treated with tight loop endobutton technique. Postoperative rehabilitation regimen was followed for all the patients. Outcome was assessed using VAS, UCLA score, DASH score and AP radiograph of affected side at regular intervals. Result: A higher prevalence of males was observed (83.3%) with mean age of 37.5 ± 12.5 years. RTA was the most common cause of injury. For clinical outcome, the mean postoperative VAS was 0.35 ± 0.48 and mean postoperative UCLA score was 29.5. 8 patients had excellent results and 16 patients had good results according to UCLA score. DASH score decreased gradually postoperatively, with significant improvement starting from the third month post-surgery. Radiologically loss of reduction was observed in only 5 cases. Conclusion: Tight loop Endobutton technique is a simple, cost-effective, one-time surgery which restores the coraco-clavicular (CC) interval and maintains it till the native ligaments heal. It proves to be an excellent alternative modality to treat the AC joint dislocation. [ABSTRACT FROM AUTHOR]