Search

In South Asia, bacterial wilt pathogens in the Ralstonia solanacearum species complex (RSSC) impose major constraints on eggplant, tomato, and pepper production. To improve the efficacy of bacterial wilt management, the goals of this study were to (i) conduct a survey of RSSC pathogens in Bangladesh and Nepal, (ii) characterize the genetic diversity of these isolates, and (iii) screen 37 tomato, eggplant, and pepper accessions for resistance to six representative isolates from South Asia. We isolated 99 isolates from Bangladesh and 20 isolates from Nepal and determined that all are phylotype I isolates of the Ralstonia pseudosolanacearum species. We sequenced and assembled draft genomes for 25 isolates. Phylogenomic analyses suggest that there is a wide diversity of endemic phylotype I isolates in South Asia and possible introductions of two clonal phylotype I lineages into Bangladesh and Nepal. We contextualize our newly described isolates based on prior reports of RSSC diversity in South Asia and global reports of RSSC pathogens on eggplant and pepper. Greenhouse trials revealed multiple tomato, eggplant, and pepper accessions that exhibit promising levels of resistance to six phylotype I isolates from South Asia. [Figure: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

High particulate matter levels in cage-free (CF) houses have led to concerns from producers, as that can pose significant risks to the health and well-being of hens and their caretakers. This study aimed to assess the effectiveness of an electrostatic particle ionization (EPI) + bedding management (BM) treatment in reducing particulate matter (PM) concentrations. Four identical CF rooms each housed 175 hens for six weeks, with two rooms assigned to the EPI + BM treatment (EPI + 20% wood chip topping over 81-week-old litter) and the other two as controls. Measurements of PM were conducted twice a week for 10 min using TSI DustTrak. Additionally, small and large particle concentrations were monitored continuously using a Dylos monitor, with a sampling period of one minute. Footpad scoring was recorded for logistic analysis. Statistical analysis was performed using ANOVA with the Tukey HSD method (p < 0.05). Results demonstrated that the EPI + BM treatment significantly reduced particle counts (37.83% decrease in small particles, 55.90% decrease in large particles) compared to the control group (p < 0.01). PM concentrations were also substantially lowered across different size fractions, ranging from 58.41% to 64.17%. These findings underscore the effectiveness of the EPI + BM treatment in reducing PM in CF houses. The integration of EPI and bedding management innovated in this study holds promise for improving air quality and contributing to the well-being of hens and caretakers in CF housing systems.

Ascochyta blight (AB) is a major threat to Kabuli-type chickpea production worldwide. This study aimed to identify AB-resistant Kabuli-type chickpea lines through combined phenotypic and genotypic screening. Twenty-six Kabuli-type chickpea lines were phenotyped at the seedling stage using spray inoculation with conidial suspension. Genotyping employed marker-aided selection (MAS) with markers linked to quantitative trait loci (QTL) for AB resistance. The allele-specific marker, CaETR, closely linked to QTLAR1, and the sequence-tagged microsatellite (STMS) markers GAA47, TAA146, and TA194 linked to QTLAR1, QTLAR2, and QTLAR3 were used to assess their utility in distinguishing between resistant and susceptible chickpea lines. The study revealed that none of the lines tested were completely resistant (R) phenotypically. However, some lines, such as AVTCPK#6 and AVTCPK#14, were found to be moderately resistant (MR). Of the two MR lines identified phenotypically, only AVTCPK#6 was found to have bands linked to QTLs for adult plant resistance. The other MR line for AB showed the presence of bands in only one or two of the four markers used. These MR lines can be further utilized in chickpea breeding programs for the development of AB-resistant chickpea cultivars. It is recommended that these results be verified through repeat experiments, using more diverse isolates, and including additional chickpea lines as reference checks for resistance and susceptibility. The allele-specific marker, CaETR, closely linked to QTLAR1 and sequence-tagged microsatellite (STMS) markers GAA47, TAA146 and TA194 linked to QTLAR1, QTLAR2, and QTLAR3 were used to explore these markers’ utility in discriminating between resistant and susceptible chickpea lines. The study showed that phenotypically, none of the lines tested are completely resistant (R). However, some lines, namely AVTCPK#6 and AVTCPK#14, were found to be moderately resistant (MR). Of the two MR lines identified phenotypically, only AVTCPK#6 was identified to have bands linked to QTLs for adult plant resistance. The other MR line for AB showed the presence of bands in only one or two markers among the four markers used. These MR lines can be exploited further in chickpea breeding programs for the development of AB-resistant chickpea cultivars. It is recommended that these results are verified by repeat experiments, using more as well as diverse isolates alongside additional chickpea lines for resistant and susceptible reference checks.

Abstract Background The recent guidelines recommend delaying elective non-neurological surgery after an index stroke, but there is a lack of consensus regarding emergency surgery in patients with a recent stroke. Impaired cerebral autoregulation and altered baroreceptor function elevate the risk of recurrent stroke in this group. Moreover, the impact of anesthesia type (general vs. regional) for non-cardiovascular, non-neurological surgery in patients with an index stroke remains inconclusive. Case presentation A 67-year-old male with an acute mild ischemic stroke underwent emergency surgery for an obstructed right-sided direct inguinal hernia under combined spinal-epidural anesthesia. Pre-operative assessment showed stable hemodynamics, and perioperative measures were taken to ensure stable blood pressure. Neuraxial anesthesia was employed successfully, and the patient remained hemodynamically stable throughout the surgery and postoperative period. No neurological deficits were observed post-surgery, and follow-up up to 3 months revealed no cognitive impairment or neurological decline. Conclusions Neuraxial anesthesia can be considered for patients with acute mild strokes requiring urgent non-neurological surgery, provided they are hemodynamically stable and without coagulopathy. However, the choice of anesthesia should be individualized based on factors such as neurological status, stroke severity, coagulation, and existing disabilities. This case highlights the importance of a personalized approach to anesthesia in emergency surgery for stroke patients.

Abstract Large mammals with general habitat needs can persist throughout mixed used landscapes, however, human-wildlife conflict frequently leads to their restriction to protected areas. Conservation efforts, especially for reducing conflicts with humans, can enhance tolerance of humans towards species like Asian elephants (Elephas maximus) in human-dominated landscapes. Here, we examine how elephant use in the Chure Terai Madhesh Landscape (CTML) covering the entire elephant range of Nepal changed between 2012 and 2020 in relationship to protection status and environmental conditions. We systematically surveyed ~ 42,000 km2 of potential habitat, by dividing the study area into 159 grid cells of 15 × 15 km2 and recorded elephant signs during the cool, dry season in three years (2012, 2018 and 2020). We analyzed the survey data in a single-species, multi-season (dynamic) occupancy modeling framework to test hypotheses regarding the influence of environmental conditions and protected area status on landscape use by elephants over time. The best-supported model included protected area effects on initial use, colonization, and detection probability as well as temporal variation in colonization and detection probability. Initial use and colonization rates were higher in protected areas, however elephants increasingly used cells located both inside and outside the protected areas, and the difference in use between protected areas and outside declined as elephants use became prevalent across most of the landscape. While elephant use was patchily distributed in the first year of surveys consistent with past descriptions of four sub-populations, elephant use consolidated into a western and eastern region in subsequent years with a gap in their distribution occurring between Chitwan and Bardiya National Parks. Our manuscript highlights the increasing landscape use by elephants in both protected areas and areas outside protected areas and suggests that management interventions that focus on reducing conflicts can promote greater use of both protected areas and areas outside of protected areas.

Escherichia coli in untreated milk leads to economic losses from subclinical mastitis and reduced milk production, while also posing a public health risk due to the emergence of antimicrobial resistant strains, particularly associated with consuming unpasteurized milk and dairy products. This study aimed to determine the prevalence and antimicrobial resistance (AMR) of E. coli isolated from buffalo milk in Siddarthanagar Municipality of Rupandehi district, Nepal. A total of 102 milk samples were collected from lactating buffaloes. The isolation and identification of E. coli were carried out using enrichment media, selective media, and biochemical tests. Antimicrobial susceptibility testing was carried out using the Kirby–Bauer disk diffusion method on Mueller–Hinton agar (Merck), according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Resistance was tested against gentamicin, amikacin, ciprofloxacin, enrofloxacin, ceftriaxone, ceftazidime, cotrimoxazole, and chloramphenicol. In addition to this, farmers were administered a questionnaire consisting of both open- and close-ended questions to identify various animal-related and management-related risk factors associated with the prevalence of E. coli. The prevalence of E. coli in our study was 29.4% (n = 30/102). Ceftriaxone and ceftazidime showed 100% resistance, while cotrimoxazole and amikacin showed 86.7% and 80% resistance, respectively. Furthermore, 86.7% of E. coli isolates were multidrug resistant (MDR). Despite suggestive trends, associations between E. coli prevalence and risk factors lacked statistical significance, necessitating further research. While some antibiotics exhibited effectiveness, many faced resistance, highlighting the need for prudent antimicrobial usage and increased awareness among farmers. Raising awareness about milk pasteurization and implementing food safety practices is essential for ensuring farmers and public health.

Introduction: Gastrointestinal (GI) parasites are major health concerns in both humans and domestic animals. Livestock farming is one of the common livelihood practices in rural Nepal. The proximity at human and domestic animal interface increases the chances of dissemination of enteric parasites, especially those of zoonotic importance. This study was aimed at finding the parasite prevalence and risk factors in both humans and their domestic animals in Jirel community. Materials and Methods: A field survey was conducted on the Jirel ethnic people and their domestic animals in Dolakha district, where a total of 152 fresh fecal samples from humans and domestic animals (cow, pigs, goats, chickens, ducks, and pigeons) were collected. The feces were examined by wet mounts and concentration techniques. A structured questionnaire survey was carried out among the local people and owners of the domestic animals to gather sociodemographic information, awareness, and hygienic practices in relation to parasite transmission Results: The enteric parasite prevalence was found to be highest in goats (80.0%;12/15), followed by pigs (55.55%;5/9), cows (45.45%;6/11), chickens (11.7%;4/34), and humans (1.41%;1/71), while the fecal samples of ducks and pigeons did not contain any parasites. The only parasite identified in humans was Ascaris lumbricoides. Similarly, three genera of GI parasites (Eimeria sp., Strongyloides sp, and Trichuris sp.) from goats, two genera each from cow (Eimeria sp. and Strongyloides sp.), pigs (Entamoeba sp. and A. suum), and chickens (Eimeria sp. and Ascaridia galli), were detected Conclusions: Based on the direct field observation, questionnaire survey and laboratory analysis, it is concluded that the Jirel community people are aware of health and hygiene; however, intervention measures are necessary to prevent parasitic infection in their domestic animals.

Among larger species of fish found in Punatsang chhu, Brown trout (Salmo trutta) and Snow trout (Schizothorax richardsonii) are notable species. Snow trout is a native species, whereas Brown trout is an introduced species. Brown trout is noted to have a negative impact on the population of native species worldwide. This study studied the population dynamics and structure of these species to detect if the introduced species affected the native species adversely. The study was conducted on a 30 km stretch of Punatsang chhu including its major and minor tributaries at about their confluences. In total, 56 sample plots of a 200 m sampling stretch were studied with a 200 m distance between each stretch. Length, weight, maturity, and sex data for both species were collected along with the habitat and water parameters. The two species were found to prefer different areas within a single stretch with a rare overlap. Snow trout were found to be distributed widely within the basin whereas Brown trout were only found in altitudes higher than 1,000 masl (x̅ = 1,231.77) and in turbid waters (p = 0.009). Recruitment of Snow trout was not good whereas recruitment of Brown trout was good. Length-frequency graphs indicated good inverse J distribution for the Snow trout population and sporadic for Brown trout. There is an effect of Brown trout introduction to the Snow trout living in the study area. Places invaded by Brown trout have a lesser presence of Snow trout compared to places not invaded by these species.

Background/Aims To describe the role of ustekinumab in inducing remission and endoscopic healing in anti-tumor necrosis factor α nonresponsive pediatric ulcerative colitis patients at a tertiary care inflammatory bowel disease center. Methods A retrospective chart review was performed on patients with ulcerative colitis receiving ustekinumab. Primary outcome was steroidfree clinical remission at follow-up. Secondary outcomes were biochemical remission and endoscopic healing. Results Ten children were analyzed; 7 (70%) had ulcerative colitis, and 3 (30%) had inflammatory bowel disease unspecified with colitis. Median follow-up period was 56 weeks. Nine patients (90%) achieved steroid-free clinical remission and biochemical remission. Seven patients had follow-up colonoscopies, out of which 6 (86%) achieved endoscopic remission, while 1 (14%) underwent colectomy. Out of the 3 patients without a follow-up colonoscopy, fecal calprotectin levels downtrended to < 150 mg/kg in 2 patients and < 400 mg/kg in 1 patient from baseline level of > 2,000 mg/kg. Conclusions Ustekinumab appears efficacious in achieving not only clinical and biochemical remission but also has promising role in inducing endoscopic healing end point in patients who fail other biologics.

Abstract Background Bacterial spot of pepper (BSP), caused by four different Xanthomonas species, primarily X. euvesicatoria (Xe), poses a significant challenge in pepper cultivation. Host resistance is considered the most important approach for BSP control, offering long-term protection and sustainability. While breeding for resistance to BSP for many years focused on dominant R genes, introgression of recessive resistance has been a more recent focus of breeding programs. The molecular interactions underlying recessive resistance remain poorly understood. Results In this study, transcriptomic analyses were performed to elucidate defense responses triggered by Xe race P6 infection by two distinct pepper lines: the Xe-resistant line ECW50R containing bs5, a recessive resistance gene that confers resistance to all pepper Xe races, and the Xe-susceptible line ECW. The results revealed a total of 3357 upregulated and 4091 downregulated genes at 0, 1, 2, and 4 days post-inoculation (dpi), with the highest number of differentially expressed genes (DEGs) observed at 2 dpi. Pathway analysis highlighted DEGs in key pathways such as plant-pathogen interaction, MAPK signaling pathway, plant hormone signal transduction, and photosynthesis – antenna proteins, along with cysteine and methionine metabolism. Notably, upregulation of genes associated with PAMP-Triggered Immunity (PTI) was observed, including components like FLS2, Ca-dependent pathways, Rboh, and reactive oxygen species (ROS) generation. In support of these results, infiltration of ECW50R leaves with bacterial suspension of Xe led to observable hydrogen peroxide accumulation without a rapid increase in electrolyte leakage, suggestive of the absence of Effector-Triggered Immunity (ETI). Furthermore, the study confirmed that bs5 does not disrupt the effector delivery system, as evidenced by incompatible interactions between avirulence genes and their corresponding dominant resistant genes in the bs5 background. Conclusion Overall, these findings provide insights into the molecular mechanisms underlying bs5-mediated resistance in pepper against Xe and suggest a robust defense mechanism in ECW50R, primarily mediated through PTI. Given that bs5 provides early strong response for resistance, combining this resistance with other dominant resistance genes will enhance the durability of resistance to BSP.

Clustering strategy in wireless sensor networks (WSNs) affects the lifetime, adaptability, and energy productivity of the wireless network system. The low-energy adaptive clustering hierarchy (LEACH) protocol is a convention used to improve the lifetime of WSNs. In this paper, a novel energy-efficient clustering algorithm is proposed, with the aim of improving the energy efficiency of WSNs by reducing and balancing the energy consumptions. The clustering-based convention adjusts the energy utilization by allowing an equal opportunity for each node to turn them into a cluster head (CH). Two-level clustering (TLC) is introduced by adopting LEACH convention where CH selection process undergoes first and second level of clustering to overcome boundary problem in LEACH protocol. The TLC method structures nodes within the scope of the appointed CHs, in order to extend the lifetime of the system. The simulation results show that, in comparison with state-of-the-art methodologies, our proposed method significantly enhanced the system lifetime.

Nepal's education system encourages disability inclusion, although limited eye sight students face problems in public schools. This study demonstrates limited eye sight students require qualified teachers to succeed in public schools. The primary objective of the study is to investigate the instructional approaches employed by regular instructors over an extended period of time to enhance the academic performance of children with limited eye sight. In Nepal, it is a common practice to include pupils with limited eye sight in public schools alongside their sighted peers. Therefore, students in public schools encountered several problems in classroom methodology and resources. Teachers’ inclusive education practice may boost limited eye sight pupils' attendance and participation in class. A good teacher created a good learning environment, used a variety of approaches, encouraged classroom activities, addressed problems, boosted student participation, and offered other support. A qualitative Narrative inquiry was conducted to learn more about a) How do teachers in regular public schools in Nepal attempt to understand and implement inclusive education practices for limited eye sight students? This research interviewed four educators from two well known regular public schools to learn more about their perspectives on inclusive education and how they implement it in their classrooms for limited eye sight students. Social capital and Inclusive theory are used to examine public school instructors' approaches to teaching limited eye sight students. This study emphasizes the need for regular communication between teachers, students, parents, and educational stakeholders to help children with limited eye sight. Classroom inclusivity can be improved through a) teaching tactics used by teachers, b) promoting equality of opportunity and a kid-friendly learning environment, and c) removing obstacles faced by pupils.

The poultry industry is shifting towards more sustainable and ethical practices, including adopting cage-free (CF) housing to enhance hen behavior and welfare. However, ensuring optimal indoor air quality, particularly concerning particulate matter (PM), remains challenging in CF environments. This study explores the effectiveness of electrostatic particle ionization (EPI) technology in mitigating PM in CF hen houses while considering the height at which the technology is placed and the duration of the electric supply. The primary objectives are to analyze the impact of EPI in reducing PM and investigate its power consumption correlation with electric supply duration. The study was conducted in a laying hen facility with four identical rooms housing 720 laying hens. The study utilized a Latin Square Design method in two experiments to assess the impact of EPI height and electric supply durations on PM levels and electricity consumption. Experiment 1 tested four EPI heights: H1 (1.5 m or 5 ft), H2 (1.8 m or 6 ft), H3 (2.1 m or 7 ft), and H4 (2.4 m or 8 ft). Experiment 2 examined four electric supply durations: D1 (control), D2 (8 h), D3 (16 h), and D4 (24 h), through 32 feet corona pipes. Particulate matter levels were measured at three different locations within the rooms for a month, and statistical analysis was conducted using ANOVA with a significance level of ≤0.05. The study found no significant differences in PM concentrations among different EPI heights (p > 0.05). However, the duration of EPI system operation had significant effects on PM1, PM2.5, and PM4 concentrations (p < 0.05). Longer EPI durations resulted in more substantial reductions: D2—17.8% for PM1, 11.0% for PM2.5, 23.1% for PM4, 23.7% for PM10, and 22.7% for TSP; D3—37.6% for PM1, 30.4% for PM2.5, 39.7% for PM4, 40.2% for PM10, and 41.1% for TSP; D4—36.6% for PM1, 24.9% for PM2.5, 38.6% for PM4, 36.3% for PM10, and 37.9% for TSP compared to the D1. These findings highlight the importance of prolonged EPI system operation for enhancing PM reduction in CF hen houses. However, utilizing 16 h EPI systems during daylight may offer a more energy-efficient approach while maintaining effective PM reduction. Further research is needed to optimize PM reduction strategies, considering factors like animal activities, to improve air quality and environmental protection in CF hen houses.

Abstract: Large-scale metagenomic and data mining efforts have uncovered an expansive diversity of bacteriophages (phages) within the human gut1–3. These insights include broader phage populational dynamics such as temporal stability4, interindividual uniqueness5,6and potential associations to specific disease states7,8. However, the functional understanding of phage-host interactions and their impacts within this complex ecosystem have been limited due to a lack of cultured isolates for experimental validation. Here we characterise 125 active prophages originating from 252 diverse human gut bacterial isolates using seven different induction conditions to substantially expand the experimentally validated temperate phage-host pairs originating from the human gut. Importantly, only 17% of computationally predicted prophages were induced with common induction agents and these exhibited distinct gene patterns compared to non-induced predictions. Active Bacteroidota prophages were among the most prevalent members of the gut virome, with extensive use of diversity generating retroelements and exhibiting broad host ranges. Moreover, active polylysogeny was present in 52% of studied gut lysogens and led to coordinated prophage induction across diverse conditions. This study represents a substantial expansion of experimentally validated gut prophages, providing key insights into their diversity and genetics, including a genetic pathway for prophage domestication and demonstration that differential induction was complex and influenced by divergent prophage integration sites. More broadly, it highlights the importance of experimental validation alongside genomic based computational prediction to enable further functional understanding of these commensal viruses within the human gut.

The article critiques two cases of cultural appropriations and explores how educators can pedagogically counter practices that normalize cultural appropriations. By examining the visual representations of Cinco de Mayo and Sherpa communities, the article illustrates how cultural appropriation often takes place through marketplace and race-neutral ideologies. The article proposes how the use of decolonizing pedagogies can counter racial stereotypes and neo/colonial knowledge productions. By examining the stereotypes, it explores how marginalized communities, locally and globally, continue to be appropriated for mainstream white consumption within curriculums. Lastly, the article explores how appropriation and commodification harm, objectify and exploit people/ communities that have historically been marginalized.

Aim/Purpose: This study explores how online writing groups facilitate the academic identity development of doctoral scholars. Background: Academic institutions around the world, and especially in developing societies, are demanding increasing amounts of research and publications from their doctoral scholars. The current study used an online writing group to facilitate writing skills development, which bolstered the academic identity development of participating scholars. Academic identity is defined as the becoming and being of an academic scholar, with writing skills as a means of acquiring and performing the status and skills of a scholar. It is reflected in the confidence, contribution, and relationship carried out in writing as a member of the academic community. Methodology: This study utilizes narrative inquiry as a research methodology to capture the experiences of six doctoral scholars from two universities in Nepal. We explore the academic identity of doctoral scholars from a sociocultural perspective, employing unstructured interviews, meeting notes, and entry and exit surveys of the online writing group. Contribution This article shows how online writing groups offer unique and impactful opportunities for networking, collaboration, and problem-solving, which can significantly enhance their writing abilities and prospects of publication, thereby fostering their intellectual agency and academic identity. Findings: This study reports three findings of the value of online writing groups: addressing gaps in formal education, community as a form of accountability, and virtual community as a platform for identity development. On the final finding of identity development, we identify and discuss four themes from data analysis: growth of self-image as scholars, strengthening of commitment to scholarship, identification of venues for expanding the scope of publication, and enhancement of digital skills. The informal and collaborative nature of online writing support facilitated socially constructivist learning, which was highly conducive to the development of academic identity among emerging scholars. Recommendations for Practitioners: It is recommended that institutions implement and encourage online writing support programs as an effective means of addressing gaps in doctoral education. While this program can fill gaps in the low-resource contexts of developing countries, it can bolster formal mentoring in any context. Recommendations for Researchers: Further research should use large-scale or longitudinal studies to explore how informal, especially online writing support and collaboration, accelerate research and writing skills, scholarly productivity, and overall academic identity formation of doctoral scholars. Impact on Society: As societies around the world accelerate their demand for doctoral degrees and also require research and publications for degree completion, new and creative approaches utilizing emerging technologies could help to fill gaps in curriculum and support systems for their doctoral scholars. Future Research: Future research could expand the scope and take a longitudinal approach for more fine-grained data and developing broader perspectives.

This paper focuses on the considerations in determining the number of participants for qualitative research because of the lack of clear guidelines in this area. The study has employed a semi-systematic literature review that is embedded with the researcher's experience. The study has concluded that the purpose of the research, methodological choices, theoretical framework and analytical strategy, data saturation, researcher's knowledge and experience, and institutional and supervisor's requirements need to be considered while choosing the participants in qualitative research. In addition, the focus has been to explore in-depth information from small number of participants. Generally, participants in qualitative research can be added or removed during the research process rather than the prior determination. This paper suggests that the researchers are autonomous to select the participants in qualitative research and they can choose from a single to twenty samples that can be varied upon the depth of the information required and the nature of the inquiry. While conducting the narrative inquiry, one to twenty or more participants can be selected with justification.

ABSTRACT This case report documents the first confirmed outbreak of African swine fever (ASF) in a wild boar (Sus scrofa) in Nepal. The case was identified in a wild boar carcass found in Shuklaphanta National Park in February 2023. Post‐mortem findings, including splenomegaly, haemorrhagic lymph nodes and congested organs, were suggestive of ASF, which was confirmed by real‐time PCR. Epidemiological evidence indicates potential transmission from nearby ASF‐infected domestic pigs. This case underscores the critical need for rigorous biosecurity protocols, comprehensive surveillance and targeted wildlife management strategies to prevent further transmission between domestic pig and wild boar populations.

Introduction: Hip and knee arthroplasty surgeries are essential for treating end-stage osteoarthritis, providing significant functional improvements. Despite a global rise in these procedures, Nepal lacks a National Joint Registry, resulting in a gap in tracking the exact number of surgeries, outcomes, and complications. This study aims to address this gap regarding the demographics of hip and knee arthroplasties in Nepal. Methods: An observational study was conducted after obtaining the ethical approval from the Nepal Health Research Council (Reference number: 2024/136) with data collected from prosthesis supplier. The study included all primary hip and knee arthroplasties performed in 2022 and 2023, excluding revision cases and those requiring mega prostheses. Data analysis was performed using Microsoft Excel for descriptive statistics. Results: There were a total of 1259 surgeries, 916 (72.77%) total knee replacements were performed, with a female predominance of 741 (81.42%) and a median age of 67 years(IQR: 62-71). There were 343 (27.23%) total hip replacements surgeries of which 200 (58.31%) were done in males. Most surgeries 1148 (91.18%) occurred within the Kathmandu Valley. Conclusions: Total knee arthroplasty accounted for the majority of cases, showing a predominance of female patients with the majority of surgeries in the capital city.

Background: Sensitivity to ionizing radiation differs between individuals, but there is a limited understanding of the biological mechanisms that account for these variations. One example of such mechanisms are the mutations in the ATM (mutated ataxia telangiectasia) gene, that cause the rare recessively inherited disease Ataxia telangiectasia (AT). Hallmark features include chromosomal instability and increased sensitivity to ionizing radiation (IR). Objectives: To deepen the molecular understanding of radiosensitivity and to identify potential new markers to predict it, human ATM-mutated and proficient cells were compared on a proteomic level. Design: In this study, we analyzed 3 cell lines from AT patients, with varying radiosensitivity, and 2 cell lines from healthy volunteers, 24 hours and 72 hours post-10 Gy irradiation Methods: We used label-free mass spectrometry to identify differences in signaling pathways after irradiation in normal and radiosensitive individuals. Cell viability was initially determined by water soluble tetrazolium (WST) assay and DNA damage response was analyzed with 53BP1 repair foci formation along with KRAB-associated protein 1 (KAP1) phosphorylation. Results: Proteomic analysis identified 4028 proteins, which were used in subsequent in silico pathway enrichment analysis to predict affected biological pathways post-IR. In AT cells, networks were heterogeneous at both time points with no common pathway identified. Mitotic cell cycle progress was the most prominent pathway altered after IR in cells from healthy donors. In particular, components of the chromosome passenger complex (INCENP and CDCA8) were significantly downregulated after 72 hours. This could also be verified at the mRNA level. Conclusion: Altogether, the most striking result was that proteins forming the chromosome passenger complex were downregulated after radiation exposure in healthy normosensitive control cells, but not in radiosensitive ATM-deficient cells. Thus, mitosis-associated proteins form an interesting compound to gain insights into the development and prediction of radiosensitivity.

ABSTRACT Human fatalities and injury from wildlife attacks often result in a negative attitude toward conservation. This research was undertaken to investigate the patterns and conflict‐causing factors of human killing and injury by large mammals, especially by Asian elephant (Elephas maximus), common leopard (Panthera pardus), and Bengal tiger (Panthera tigris tigris) in the Bardia—Banke Complex of western Nepal. We collected human death and injury records caused by wildlife in the Bardia—Banke Complex between 2019 and 2023, based on relief applications submitted by the victim's family. Additionally, camera trap monitoring was conducted following incidents of human–tiger and human–leopard conflicts. A total of 76 incidents involving human casualties and injuries were considered for analysis. Incidents of livestock depredation, crop raiding, and property damage were excluded from the analysis. Most of the attacks on humans were caused by tigers (75%), followed by elephants (16%) and leopards (9%). Almost all incidents occurred in daytime (97%). The highest number of conflicts were recorded in 2021, with 20 incidents. Most of the cases (84%) occurred within 1 km of forest edge. Khata corridor and the western side of the Bardia National Park, i.e., Karnali River corridor, were identified as high‐conflict areas. The primary causes of the conflict manifested in cattle grazing (28%), grass cutting (28%), firewood collection (11%), fishing (8%), vegetable collection (5%), sand collection (4%), during rescuing friends (3%), grazing captive elephants (3%), highway rides (3%), sleeping in Chaupadi Goth (3%), walking nearby forest areas (3%), playing nearby forest areas (1%), while feeding pig (1%), and working in agricultural lands (1%). To promote human–wildlife coexistence, community‐based patrols (33%), habitat restoration (26%), electric fencing (26%), and insurance (7%) were identified as the preferred strategies. Therefore, we recommend that stakeholders and concerned bodies increase awareness among local community about the use of forest resources, wildlife behavior, and human–wildlife conflict mitigation strategies.

Key Clinical Message Early initiation of anti‐retroviral treatment and prompt management of heart failure in a AIDS patient is crucial. If resources available endomyocardial biopsy can guide the future management. Abstract HIV‐associated cardiomyopathy (HIVAC) is a serious complication of HIV with poorly understood pathology. Systolic dysfunction was a common characteristic of HIVAC which is now replaced as diastolic dysfunction due to the availability of ART. There are various etiologies of HIVAC depending on the degree of viral replication, immune response, availability of ART, and also the disparity between high and low‐income countries. We present the case report of a 65‐year‐old male with a past medical history of untreated HIV who came to the hospital with hemodynamic instability and was diagnosed with HIVAC with pulmonary TB, where the cause of HIVAC was poor immune response and opportunistic infection. Therefore, early cardiac monitoring is essential in HIV patients to prevent its advancement.

Rapid urbanization and evolving dietary preferences have heightened the demand for durum wheat and its derivatives in developing nations like Nepal. This study represents the first comprehensive exploration and evaluation of durum wheat genotypes in Nepal, addressing the escalating need for high-yielding varieties. The primary objective was to identify stable and prolific durum wheat lines for release, enhancing Nepal’s durum wheat breeding program. Utilizing genotypes from CIMMYT’s disease screening and yield nurseries from 2011/12 to 2020/21, a total of 132 genotypes, including international checks, underwent evaluation over ten years under the Alpha Lattice design. Results revealed significant variation among genotypes for grain yield and other traits, identifying high-yielding and stable lines suitable for Nepal. Heritability analysis highlighted moderate heritability for grain number per spike, thousand-grain weight, and grain yield. Cluster analysis identified distinct clusters with high grain yield and desirable agronomic traits. Disease incidence facilitated the selection of resistant lines, with DWK38 emerging as the highest grain yielder (4416.04 kg/ha). Overall, durum wheat lines from CIMMYT exhibited robust performance in Nepal, enabling the identification of superior lines with potential benefits for farmers and consumers. The study’s implications include developing and releasing superior durum lines in Nepal, providing farmers with profitable alternatives amidst evolving food habits. In conclusion, the findings from this study provide a valuable foundation for future durum wheat breeding efforts in Nepal, guiding the selection of genotypes that are well-suited to the diverse environmental challenges of the region.

Abstract When implementing optoelectronic devices through the stacking of heterogeneous materials, considering the bandgap offset is crucial for achieving efficient carrier dynamics. In this study, the bandgap offset characteristics are investigated when n‐type gallium nitride nanowires (n‐GaN NWs) are used as electron transport layers in methylammonium lead iodide (MAPbI3)‐based optoelectronic devices. n‐GaN NWs are grown on indium‐tin‐oxide (ITO)‐coated glass via the plasma‐assisted molecular beam epitaxy (PA‐MBE) process to form the “GaN NWs‐on‐glass” platform. A MAPbI3 thin film is then spin‐coated on the GaN NWs‐on‐glass. X‐ray photoelectron spectroscopy (XPS) shows that the valence and conduction band offsets in the MAPbI3/n‐GaN heterostructure are 2.19 and 0.40 eV, respectively, indicating a type‐II band alignment ideal for optoelectronic applications. Prototype photovoltaic devices stacking perovskite on GaN NWs‐on‐glass show excellent interfacial charge‐transfer ability, photon recycling, and carrier extraction efficiency. As a pioneering step in exploiting the diverse potential of the GaN‐on‐glass, it is demonstrated that the junction characteristics of MAPbI3/n‐GaN NW heterostructures can lead to a variety of optoelectronic device applications.

The Ti2Cu intermetallics compound possessing an ability to release Cu2+ ions has promising antibacterial properties. This research integrates experimental and computational techniques to delve into the interfacial intermetallic (IMC) formation within the Ti6Al4V/Cu system. Heat transfer analysis is performed to numerically outline the thermal history within the microstructure during laser surface alloying (power = 1000 W and scan speed = 200 mm/s), while the phase field method is employed to describe the Ti2Cu IMC grain growth in the Ti6Al4V matrix. As the IMC and the matrix phases respectively have free energy minima of -68.52 and -61.35 kJ/mol at Taverage=1250.0 K, the growth of Ti2Cu IMC grains at the Ti6Al4V matrix located around the depth of 5 μm from the top surface is thermodynamically favorable. Laser processing can cause the nucleation of IMC precipitates of irregular sizes and curvature profiles, in which case the curvature driven effects between the adjacent grains can additionally affect their growth kinetics. Furthermore, microbiological assays underscore the superior antibacterial efficacy of the Ti6Al4V+Ti2Cu heterostructures as compared to the control (Ti6Al4V) counterpart.

The extinction of megafauna, such as rhinos, from tropical Asian forests may have detrimental effects on the regeneration of plant species that rely heavily on their dispersal services. Understanding the potential of other animals to substitute the ecological function of megafauna is important for predicting ecosystem change following declines or extirpation of megafauna. Anthropogenic activities have led to the presence of domestic bovids in many tropical habitats, and these animals could be capable of substituting seed dispersal roles of megafauna. Here, we conducted feeding trials, germination tests, and collected movement data on greater one-horned rhino (Rhinoceros unicornis) and domestic bovids (Bos primigenius; Bubalus bubalis) in the national parks of Chitwan and Shuklaphanta, Nepal. Our aim was to investigate whether domestic bovids can serve as effective substitutes for rhinos in dispersing the megafaunal-fruited Mallotus nudiflorus, which are specialized for rhino dispersal. Specifically, we assessed the long-distance seed dispersal capabilities of rhinos and bovids by combining gut passage times and movement patterns. Additionally, we compared the seed germination success rates among rhinos, bovids and other dispersal modes (e.g., deer and water dispersal). We found that rhinos dispersed 80 percent of seeds over distances greater than 1 km, with potential dispersal distances of up to approximately 5.4 km within their maximum gut passage time. In contrast, cattle dispersed 20 percent of seeds over 1 km, with a maximum distance of around 2.2 km, while buffaloes dispersed 15 percent of seeds over 1 km, with a maximum distance of around 1.4 km. Seeds consumed by rhinos exhibited similar or better germination rates compared to seeds retrieved from cattle and buffalo dung, as well as other dispersal modes. These findings indicate that rhinos provide a functionally unique dispersal service for this megafaunal fruit, especially in long-distance dispersal. While domestic bovids can partially substitute the seed dispersal functions of rhinos, they cannot fully compensate for the loss of seed dispersal that occurs with the disappearance of rhinos.

Key Clinical Message Hypocalcemia is one of the rarest causes of reversible cardiomyopathy. Patients with refractory heart failure need to be explored for hypocalcemia and need prompt correction. Abstract Hypocalcemia is a rare cause of reversible dilated cardiomyopathy. Correction of calcium is crucial to recover left ventricular function and structure. We presented the case of a 55‐year‐old female who was admitted to the hospital with refractory heart failure due to hypocalcemia induced by primary hypoparathyroidism and complicated by vitamin D deficiency. The patient's cardiac symptoms improved dramatically upon correction of hypocalcemia, and vitamin D. Therefore, the key clinical message of this case report is, that hypocalcemia, although rare, should be considered as one of the differential diagnoses when heart failure is refractory and early diagnosis and treatment is necessary as it is the cause of reversible cardiomyopathy and could reduce morbidity and mortality.

Key Clinical Message Ovarian hemangioma, though rare and asymptomatic, can mimic malignant ovarian tumors, thus it is necessary for comprehensive histopathological and immunohistochemical evaluation for accurate diagnosis and appropriate management.

Key Clinical Message This case illustrates sarcoidosis as a potential complication of COVID‐19, highlighting the need for a comprehensive diagnostic approach, including histopathology and prolonged monitoring, to distinguish it from post‐COVID fibrosis. Further research is crucial to elucidate these associations and understand their underlying mechanisms. Abstract Severe Acute Respiratory Syndrome Coronavirus‐ 2 (SARS‐CoV‐2), a positive‐sense single‐stranded RNA virus, causes COVID‐19 and has been linked to autoimmune disorders. Sarcoidosis is a multi‐system disease that is frequently triggered by infections. It is characterized by non‐necrotizing granulomas in multiple organs. We present a case of sarcoidosis as rare sequelae of COVID‐19. A 26‐year‐old man presented with mild COVID‐19 symptoms, followed by prolonged fever and cough despite initial therapy, prompting a provisional diagnosis of post‐COVID fibrosis. A subsequent assessment at a tertiary hospital revealed dyspnea, weight loss, and abnormal chest imaging, all of which were consistent with pulmonary sarcoidosis with pulmonary tuberculosis as a differential diagnosis. A biopsy taken during bronchoscopy confirmed pulmonary sarcoidosis and treatment with inhalation steroids resulted in symptom relief, which was followed by remission with oral steroid therapy. Sarcoidosis is a systemic disease of unknown etiology, characterized by non‐necrotizing granulomas in multiple organs. It may be triggered by infections and involves an abnormal immune response. COVID‐19 can potentially initiate sarcoidosis, with both sharing common immune mechanisms. Diagnosis involves imaging and biopsy, and treatment typically includes glucocorticoids and regular monitoring. This case report emphasizes the potential link between COVID‐19 and autoimmune conditions like sarcoidosis, highlighting the need for a comprehensive diagnostic approach and long‐term observation to distinguish between sarcoidosis and post‐COVID fibrosis.

Key Clinical Message Appropriate anesthetic technique for fracture fixation in multiple myeloma is crucial in minimizing perioperative complications. The use of pericapsular nerve group block followed by spinal anesthesia for the operative management of pathological fracture in multiple myeloma patient along with proper pre‐ and postanesthetic care ensures better outcome for the patient. Abstract Multiple myeloma is a malignant plasma cell disease that often presents with anemia, renal failure, hyperkalemia and osteolytic bone lesions. The advancements in drug therapy of multiple myeloma have prolonged the lifespan of the affected people, resulting in a rise in cases of surgical management of fractures in such patients. Anesthetic management, despite being of utmost importance in minimizing perioperative complications in such patients, has not been widely studied, especially in this part of the world. Hence, we report a case of 64 years diabetic, HbSAg positive male with hypothyroidism and a known case of multiple myeloma since the last 6 years, under medication for his comorbidities who suffered acetabular fracture. In this case report, the use of pericapsular nerve group block followed by spinal anesthesia for the operative management of the fracture has been discussed along with several pre‐ and postanesthetic considerations. With appropriate anesthetic techniques and proper pre‐ and postanesthetic care, better outcomes can be guaranteed.

Abstract BackgroundCognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. ObjectiveThe objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. MethodsData from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults’ daily adherence to cognitive training programs. ResultsOur results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. ConclusionsOur findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.

Objectives This study was conducted to assess the prevalence of tobacco use, secondhand smoke (SHS) exposure and knowledge about SHS and third-hand smoke (THS) exposure among students in a medical college in Western Nepal.Design This is a cross-sectional study.Setting Data collection was done from 8 July 2023 to 8 August 2023 in a medical college in Nepal.Participants This study was conducted on undergraduate students studying in a medical college in Western Nepal using a census (whole population) sampling technique.Main outcome measures Prevalence of tobacco use was assessed by asking a question, ‘Did you use tobacco products within the last 30 days?’. Secondhand smoke exposure and knowledge about SHS and THS exposure were assessed by using structured questionnaires. The χ2 test was used to compare the group exposed and non-exposed to tobacco, SHS and THS by sociodemographic variables (sex, residence, year of study and academic stream).Results The response rate was 96.43% (n=595/617). The overall prevalence of tobacco use was found to be 16.30%. A total of 88.83% of students from clinical years knew about SHS which was more than preclinical students (p