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Introduction The Kayakalp guidelines for public healthcare facilities under the Swachh Bharat Abhiyan (Clean India Mission) focus on improving sanitation, cleanliness, and infection control at public hospitals in India. This study was conducted in a 960-bed tertiary-level teaching hospital in eastern India. Housekeeping has been a challenge in public institutions, with factors like overcrowding and resource constraints. Tobacco and betel nut chewing, spitting, poor sanitation practices, and open urination are major challenges in ensuring sanitation at the hospital. The research objective was to study the implementation of the Kayakalp guidelines for quality improvement in housekeeping services at the institution. Methods A pre- and post-interventional study was conducted using the Plan-Do-Check-Act (PDCA) quality tool. Plan phases included the gap assessment using the Kayakalp checklist with numerical scoring. Necessary interventions were done under three headings: structure, processes, and outcomes in the “Do” phase. The “Check” phase included monitoring of the activities followed by the “Act” phase, which included a review of the action plan. External experts nominated by the government conducted the final assessments and recommended it as one of the cleanest hospitals. Results A 360-degree improvement was observed in hospital services, with assessment score improvement from 73.68% to 95.0%. The institution received the first prize in 2020 and 2021 and runners-up Kayakalp National Award under category “B” (Institute of National Importance) Hospitals in 2019. Conclusion The implementation of Kayakalp guidelines of the Government of India proved to be efficient in the improvement of housekeeping and infection control practices in the institution.

Background: Scorpion sting can pose as a life threatening acute medical emergency, which, if not attended to on an emergency basis can result in mortality. Scorpion venoms are a composed of a complex mixture of proteins. There has been documentary evidence that scorpion antivenom and prazosin, an alpha blocker are very effective in reducing the mortality rate following scorpion bite. Aim: To compare the time required for complete resolution of the autonomic manifestations associated with prazosin alone and prazosin with antiscorpion venom in children with scorpion sting envenomation. Methods: This was a cohort study including 44 children less than 18 years of age, presenting to the paediatric emergency or outpatient department with scorpion sting within 10 hours of sting from the 2 hospitals attached to J.J.M Medical College, Bapuji Child Heath Institute and C.G Hospital from November 2019 to November 2021. Results: The mean age was 10.35 ± 3.76 in the prazosin + antivenom group and in the prazosin group was 11.58±3.87 years. Males were commonly affected. In the present study, overall, 14 cases (16.67%) presented within 4 hours of bite and 30 (83.3%) cases after 4 hours of bite. The clinical features seen in the prazosin alone group and prazosin + anti venom group was cold extremities, excessive sweating, CNS effects and cardiac involvement. 58.33% had evidence of grade 3 envenomation. The days of hospitalization was 5.39 days +2 .72 days in the group prazosin + antivenom and in the group prazosin alone it was 9.27+ 4.57 days. Higher doses of prazosin were used in those who received prazosin alone ,mean was 8.50 SD +1. 89 and in group prazosin +antivenom, the mean was 6.00SD +2.11. Higher post medication cardiac dysfunction was seen in prazosin + antivenom, i.e 27.27% and the group prazosin alone it was 9.09%. Conclusion: As compared to prazosin alone the combination of prazosin with antivenom is very effective by reducing the time to alleviate the autonomic over activity.

Early and reliable detection of land degradation helps policymakers to take strict action in more vulnerable areas by making strong rules and regulations in order to achieve sustainable land management and conservation. The detection of land degradation is carried out to identify desertification processes using machine learning techniques in different geographical locations, which are always a challenging issue in the global field. Due to the significance of the detection of land degradation, this article provides an exhaustive review of the detection of land degradation using machine learning algorithms. Initially, the current status of land degradation in India is presented, along with a brief discussion on the overview of widely used factors, evaluation parameters, and algorithms used. Consequently, merits and demerits related to machine learning-based land degradation identification are presented. Additionally, solutions are prescribed in order to reduce existing problems in the detection of land degradation. Since one of the major objectives is to explore the future perspectives of machine learning-based land degradation detection, areas including the application of remote sensing, mapping, optimum features, and algorithms have been broadly discussed. Finally, based on a critical evaluation of existing related studies, the architecture of the machine learning-based desertification process has been proposed. This technology can fulfill the research challenges in the detection of land degradation and computation difficulties in the development of models for the detection of land degradation.

Abstract Many Asian elephant populations inhabit fragmented human‐dominated landscapes. Human–elephant conflict (HEC) has intensified in such regions, resulting in the deaths of hundreds of people and elephants each year. Controversy between stakeholders then arises as people debate the merits of HEC mitigation approaches, stifling progress. We conducted a survey to evaluate the opinions of experts, farmers and others who have and have not experienced HEC (n = 611), on the causes of HEC, the importance of, conservation of and co‐existence with elephants, and on the acceptability and effectiveness of potential HEC mitigation methods. Analysis of variance and the Potential for Conflict Index showed that all groups agreed with nine of the 10 causes of HEC assessed, on average. All respondent groups had mostly positive attitudes towards the importance and conservation of elephants. However, farmers exposed to HEC disagreed that people should co‐exist with elephants and supported the view that elephants should be removed from human habitats. All groups agreed on the acceptability and effectiveness of electric fencing, early warning systems with infrasonic call detectors, Global Positioning System collars and geophones. However, there was disparity in views between the experts and other stakeholder groups on the acceptability and effectiveness of restricting elephants to protected areas, and translocation of problem elephants to protected areas away from their capture site or to wild elephant holding grounds. While similar views between stakeholders on many subjects are encouraging for elephant conservation, the disparities identified should be given greater attention when planning HEC management programs to minimize conflict between stakeholders.

In the field of composite materials, extensive research has been undertaken on aluminum-graphite composites. However, a research gap has been identified regarding the specific influence of nano-sized graphite particles on their fracture toughness. Previous studies have predominantly focused on larger graphite particles or different reinforcement materials, resulting in relatively unexplored effects of nano-graphite particles. This research is deemed critical as it has the potential to generate lightweight, high-strength materials, aligning with the demands of aerospace, automotive, and structural engineering. The primary objective of this study is to investigate how the inclusion of nano-sized graphite particles affects the fracture toughness of aluminum-graphite composites. To achieve this objective, systematic dispersion and incorporation of nano-sized graphite particles into an aluminum matrix will be carried out. Mechanical testing, including fracture toughness assessments, will be conducted to evaluate the performance of the composite materials. Factors such as particle size, distribution, volume fraction, and interfacial bonding will also be characterized within the study. It is anticipated that the presence of nano-sized graphite particles will lead to a significant enhancement of the fracture toughness of the aluminum-graphite nanocomposites. This enhancement is expected to be attributed to crack deflection, tortuosity, altered stress distribution, and increased plastic deformation around cracks.

Plant annexins are a multigene family of phospholipid-binding, calcium-dependent proteins that respond to signals and environmental challenges as plants grow and develop. Plant annexins are functionally unique due to their ATPase/GTPase, peroxidase, and calcium (Ca2+) channel-regulating activities. They play a major role in controlling many different aspects of cellular and metabolic functions, plant growth and development, and reactions to both biotic and abiotic environmental stimuli. In this review, we provide an overview of how intracellular and extracellular annexins work, mechanism of reactive oxygen species (ROS) and annexins, highlight recent developments of the roles of annexins in abiotic stress tolerance in plants, and emphasize the role of annexins in plant growth and development.

AbstractCorporate efforts in eradicating environmental negativities are a significant aspect that is playing a vital role to contribute sustainable development. Renewable energy initiatives by corporations are also a trending effort through which they can promote the generation and consumption process of clean energy that helps to conserve non-renewable natural resources and contributes to the same for future generations. Therefore, the study followed both quantitative and qualitative approaches to achieve the objectives. The qualitative approach consists of content analysis of earlier literature and theories and focus group discussions for finalizing the research instrument. The research instrument was distributed to managers and academicians through e-forms, 271 responses were received and 253 completed responses were considered for further analysis. The study employed descriptive statistics, structural equation modelling, and mediation analysis techniques to draw conclusions based on the objectives. The results of the one-sample t-test revealed that the respondents positively opined that renewable energy initiatives by corporations influence sustainable development. Further, the results of structural equation modelling and mediation analysis confirmed the influence of such initiatives have an indirect influence on sustainable development, mediated by the environmental, social, and economic aspects. The outcomes of this study help industries to know the importance of such initiatives and provide inputs to design their business models based on such initiatives and also guides to frame the policies to align their operations with sustainability. Further, the outcome also helps to correlate complex relationships between corporations’ actions and sustainable development goals. Lastly, the study contributes to the existing body of knowledge on the intersection of corporations’ initiatives, renewable energy, and sustainable development. Advancing the research in this field paves the way for future research and to frame policies for fostering sustainable business practices and addressing environmental issues.

ObjectivesPreterm birth occurs in more than 10% of U.S. births and is the leading cause of U.S. neonatal deaths, with estimated annual costs exceeding $25 billion USD. Using real-world data, we modeled the potential clinical and economic utility of a prematurity-reduction program comprising screening in a racially and ethnically diverse population with a validated proteomic biomarker risk predictor, followed by case management with or without pharmacological treatment.MethodsThe ACCORDANT microsimulation model used individual patient data from a prespecified, randomly selected sub-cohort (N = 847) of a multicenter, observational study of U.S. subjects receiving standard obstetric care with masked risk predictor assessment (TREETOP; NCT02787213). All subjects were included in three arms across 500 simulated trials: standard of care (SoC, control); risk predictor/case management comprising increased outreach, education and specialist care (RP-CM, active); and multimodal management (risk predictor/case management with pharmacological treatment) (RP-MM, active). In the active arms, only subjects stratified as higher risk by the predictor were modeled as receiving the intervention, whereas lower-risk subjects received standard care. Higher-risk subjects' gestational ages at birth were shifted based on published efficacies, and dependent outcomes, calibrated using national datasets, were changed accordingly. Subjects otherwise retained their original TREETOP outcomes. Arms were compared using survival analysis for neonatal and maternal hospital length of stay, bootstrap intervals for neonatal cost, and Fisher's exact test for neonatal morbidity/mortality (significance, p

AbstractBackgroundClinical risk factors for preeclampsia (PE), including previous PE, chronic hypertension, and pregestational diabetes, are poorly predictive of PE. Preterm PE, defined as diagnosis of PE with delivery prior to 37 weeks’ gestational age (GA), is more likely to be associated with serious morbidities and difficult clinical decision making. Therefore, there remains an urgent clinical need to develop a safe, feasible, and accurate predictor of preterm PE that integrates molecular biomarkers and relevant clinical factors into a single risk assessment score that can be used to guide clinical management.Objective(s)To discover, verify, and validate a mid-trimester proteomic biomarker risk predictor for preterm PE, comprised of a composite clinical variable and a small number of maternal serum analytes.Study DesignThis was a secondary analysis of data from two large clinical trials (PAPR,NCT02787213; TREETOP,NCT01371019). PAPR subjects’ eligibility was limited to those who had consented to research into preterm birth and pregnancy complications and who had blood drawn between 180/7– 226/7weeks’ gestation. TREETOP subjects were limited to those who had blood drawn between 180/7– 206/7weeks’ gestation. PAPR subjects were assigned to a discovery cohort, and TREETOP subjects were randomly assigned to a first-phase cohort for verification (comprised of one-third of eligible subjects) and to a separate second-phase cohort for validation (comprised of the remaining two-thirds of eligible subjects). Peptides were analyzed by liquid chromatography-multiple reaction monitoring mass spectrometry measuring 77 pregnancy-related proteins and quality control proteins. Models were limited to a maximum of one additional protein ratio and a composite clinical variable, referred to as Clin3, which was deemed positive if any of three factors was true for the subject: prior PE; pre-existing hypertension; and/or pregestational diabetes. Overall classifier performance was assessed via area under the receiver operating characteristic curve (AUC).ResultsVerification yielded nine multi-component classifier models for prediction of preterm PE, all of which were subsequently validated. Classifiers exhibited greater predictive performance than clinical factors alone. Example performance metrics across a range of classifier score thresholds and GA at birth cutoffs of 37, 34 and 32 weeks for the Clin3 + inhibin subunit beta c (INHBC)/SHBG classifier, which showed the highest AUC, demonstrating a sensitivity of 89% at a specificity of 75% for prediction of early-onset preeclampsia (

The importance of antioxidants has gained much attention due to the increase in the prevalence of various non-communicable diseases such as cancer, diabetes mellitus, and cardiovascular diseases, which occur due to excess reactive species. The widespread use of synthetic antioxidants in the food industry has raised concerns about their potential harmful effects on health. As a result, the utilization of natural antioxidants to preserve food and as a source of dietary antioxidants has gained attention. Essential oils extracted from Apiaceae family plants are an excellent source of antioxidants. In this review, research findings regarding the antioxidant activity of selected Apiaceae family members and their applications are discussed.

Annona fruit, leaves, seeds, roots, and bark have been conventionally used in many countries for medical treatments as they are considered ideal sources of pharmacologically active compounds, but Annona remains an underutilized fruit in many countries. The fruit of these plants is delicately flavored and is used in industrial products such as ready-to-serve beverages, wine, jellies, jam, and fruit-butter preserve, while the seeds generally go to waste. Annona seed oil contains numerous health-benefiting factors such as vitamins, minerals, bioactive compounds, fatty acids, antioxidants, and phenolic compounds, which are responsible for various biological activities, including antibacterial, antioxidant, and antitumor activities. Cancer is a worldwide major health problem that remains unresolved. Even though the current treatments can manage to reduce tumor growth, there is an urgent need to investigate more efficient but less expensive novel techniques to overcome some of the restrictions in treating tumors. Annona might offer an indispensable choice besides chemotherapy and radiotherapy, especially for terminally ill patients, as the Annona genus contains secondary metabolites in nearly every component of Annona plants. Research has shown that many Annona species contain promising components that could potentially exhibit anticancer activity, but the information available is scarce and inconsistent. Annona muricata (Soursop, “Katuanoda”), Annona squamosa (Sweetsop, “Seenianoda”), and Annona reticulata (Custard apple, “Welianoda”) are three commonly cultivated edible Annona species in Sri Lanka. The main objective of the review was to present an updated comprehensive literature analysis of the putative chemopreventive functions against cancer cell lines/the anticancer effect on cancers, phytochemical properties, and antioxidant properties possessed by the seed oils of three selected common Annona species. Although there are some in vitro and in vivo experimental investigations supporting the benefits of Annona seed oils, clinical investigations are still needed to explore concealed areas, determine the effects on the human body, determine the safest concentration, and determine health-contributing benefits before they are submitted to clinical trials.

As exemplified during the COVID-19 pandemic and in post-operative intensive care units, monitoring blood oxygen saturation (SpO2) levels is crucial in terms of assessing a patient’s health condition. Due to random movements of the subject, a pulse-oximeter-driven photoplethysmographic (PPG) signal becomes noisy while recording, with motion artefacts (MAs), which will disturb the morphological features, leading to incorrect SpO2 levels. The MA noise may contain either low- or high-frequency components, resulting in a scenario with inband and out-of-band noise. The reduction of in-band noise with an adaptive filter requires a reference signal, and an additional sensor such as an accelerometer is normally used in addition to the PPG sensor to capture the MAs. The present work focuses on the generation of a reference for inherent noise using a wavelet transform (WT), thereby eliminating the need for an external sensor. The computed values of the correlation coefficient and magnitude squared coherence are used to establish the validity of the generated inherent noise reference. Our WT-driven adaptive filtering method reduces MAs, simplifies the correct approximation of the SpO2 and heart rate, and also restores the respiratory components. The de-noised PPG signals presented here and a corresponding numerical study prove the usefulness of the proposed method, which has a worstcase accuracy of 0.5% in regard to SpO2 estimations.

To provide service to an abundant number of communication users and to avoid the spectrum scarcity problem, many researchers are fascinated to work towards the convergence of radar sensing and communication systems. In addition, future intelligent systems like autonomous vehicles, Vehicle-to-everything (V2X), Unmanned Aerial Vehicles (UAV), and all smart systems are going to implement both radar and communication systems on the same platform, which motivates the researchers to focus on the development of Joint Radar-Communication Systems (JRCS). Cooperative Radar-Communication System (CRCS) and Dual Functional Radar Communication (DFRC) systems provide an opportunity for communication users to utilize radar resources without disturbing radar operation. Waveform design is essential in the development of new models and designs related to joint radar-sensing and communication systems. A cooperative radar communication system uses separate waveforms for radar and communication systems. The DFRC system uses the same waveform for radar and communication operations. So to model both joint radar communication systems one should have a clear idea regarding waveform design and its approaches. Therefore, this review paper focused on different waveform design approaches for modeling CRCS and DFRC systems. In addition, the prime objective of this review paper is to give a detailed view of the existing cooperative and dual-function waveform design approaches and provide a kick-start for new learners to work on this area.

The widespread usage of the Radio Frequency (RF) spectrum for wireless and mobile communication systems generated a significant spectrum scarcity. The Joint Radar-Communication System (JRCS) provides a framework to simultaneously utilize the allocated radar spectrum for sensing and communication purposes. Generally, a Successive Interference Cancellation (SIC) based receiver is applied to mitigate mutual interference in the JRCS configuration. However, this SIC receiver model introduces a communication residual component. In response to this issue, the article presents a novel measurement model based on communication residual components for various radar waveforms. The radar system's performance within the JRCS framework is then evaluated using the Fisher Information Matrix (FIM). The radar waveforms considered in this investigation are rectangular pulse, triangular pulse, Gaussian pulse, Linear Frequency Modulated (LFM) pulse, LFM-Gaussian pulse, and Non-Linear Frequency Modulated (NLFM) pulse. After that, the Kalman filter is deployed to estimate the target kinematics (range and range rate) of a single linearly moving target for different waveforms. Additionally, range and range rate estimation errors are quantified using the Root Mean Square Error (RMSE) metric. Furthermore, the Posterior Cramer-Rao Lower Bound (PCRLB) is derived to validate the estimation accuracy of various waveforms. The simulation results show that the range and range rate estimation errors are within the PCRLB limit at all time instants for all the designated waveforms. The results further reveal that the NLFM pulse waveform provides improved range and range rate error performance compared to all other waveforms.

Edwardsiella tarda (E. tarda), a gram-negative bacillus, a member of order Enterobacterales, is typically a fish pathogen frequently isolated from fresh and brackish water environments. It is very rarely implicated in human infections such as gastroenteritis (most common), cellulitis, gas gangrene, hepatobiliary infections, peritonitis, empyema, and meningitis. Bacteremia/sepsis caused by E. tarda can be fatal in humans, although very rare (

Introduction and Objectives The availability of a limited arsenal of antibacterial agents effective against Burkholderia pseudomallei, the causative agent of melioidosis, together with sporadic reports of emergence of resistance necessitates an evaluation of in vitro activity of new antimicrobials against clinical B. pseudomallei isolates. Cefiderocol (CFDC), a novel siderophore cephalosporin, and ceftazidime-avibactam (CZA), a new β lactam combination agent, have shown promising results for the treatment of difficult-to-treat Gram-negative bacilli infections with limited treatment options. This study was conducted to determine the in vitro activity of CFDC and CZA against a contemporary collection of 60 B. pseudomallei clinical isolates.