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The increasing global temperatures and thermal islands have made cooling living spaces a pressing issue. Climate change and global energy use cause thermal islands. Greenhouse gas emissions and increasingly expensive and scarce energy supplies are causing disruptive global climate change. The use of energy, heat production, and greenhouse gas emissions caused by building air-conditioning increase the demand for cooling in developed environments. The dearth of sufficient electrical infrastructure for cooling buildings has increased summertime fatalities, including in places such as South Asia and Sub-Saharan Africa. Energy efficiency mitigates the rising cost of energy by reducing those emissions. The rise in surface temperature due to sunlight absorption needs to be reradiated to the sky, or it will conduct through roof spaces toward the ceiling and radiate downwards through insulation batts. Passive cooling technologies, which are environmentally friendly substitutes for extensions of aggressive cooling techniques can solve these problems. In this instance, we focus on the passive daytime radiative cooling of building envelopes and suggest that inorganic composition-based paints are well-suited for use in buildings worldwide. Selective absorption or scattering of light alters the appearance of the coating through inorganic composition. The present investigation focuses on incorporating various inorganic compositions into paint and reducing surface temperature after applying it to walls. [ABSTRACT FROM AUTHOR]

Background and Aim: While European Society of Pediatric Gastroenterology Hepatology and Nutrition advocates a no‐biopsy pathway for the diagnosis of celiac disease (CeD) in children if IgA anti‐tissue transglutaminase antibody (anti‐tTG ab) titer is ≥10‐fold upper limit of normal (ULN) and have a positive IgA anti‐endomysial antibody (EMA); the data for anti‐tTG Ab titer‐based diagnosis of CeD in adults is still emerging. We planned to validate if IgA anti‐tTG Ab titer ≥10‐fold predicts villous abnormalities of modified Marsh grade ≥2 in Asian adult patients with CeD. Methods: We recruited 937 adult patients with positive anti‐tTG Ab from two databases, including AIIMS Celiac Clinic and Indian National Biorepository. The diagnosis of definite CeD was made on the basis of a positive anti‐tTG Ab and the presence of villous abnormalities of modified Marsh grade ≥2. Results: Of 937 adult patients with positive anti‐tTG Ab, 889 (91.2%) showed villous abnormalities of modified Marsh grade ≥2. Only 47.6% of 889 adults with CeD had anti‐ tTG Ab titers of ≥10‐fold. The positive predictive value (PPV) and specificity of anti tTG Ab titer ≥10‐fold for predicting modified Marsh grade ≥2 were 99.8% and 98%, respectively. At anti‐tTG Ab titer ≥11‐fold, specificity and PPV were 100% for predicting villous abnormalities of modified Marsh grade ≥2. Conclusions: Approximately 50% of adults with CeD may benefit from the no biopsy pathway, reducing the health burden and risks of gastroscopy/anesthesia. [ABSTRACT FROM AUTHOR]

Background and Aim: Celiac disease (CeD) has now become a global disease with a worldwide prevalence of 0.67%. Despite being a common disease, CeD is often not diagnosed and there is a significant delay in its diagnosis. We reviewed the impact of the delay in the diagnosis on the severity of manifestations of CeD. Methods: We reviewed clinical records of 726 consecutive patients with CeD from the Celiac Clinic database and the National Celiac Disease Consortium database. We extracted specific data including the demographics, symptoms at presentation, time of onset of symptoms, time to diagnosis from the onset of the symptoms, and relevant clinical data including fold‐rise in anti‐tissue transglutaminase antibody (IgA anti‐tTG Ab) and severity of villous and crypt abnormalities as assessed using modified Marsh classification. Results: The median duration between the onset of symptoms and the diagnosis of CeD was 27 months (interquartile range 12–60 months). A longer delay in the diagnosis of CeD from the onset of symptoms was associated with lower height for age, lower hemoglobin, higher fold rise in IgA Anti tTG titers, and higher severity of villous and crypt abnormalities. About 18% of patients presented with predominantly non‐gastrointestinal complaints and had a longer delay in the diagnosis of CeD. Conclusions: There is a significant delay in the diagnosis of CeD since the onset of its symptoms. The severity of celiac disease increases with increasing delay in its diagnosis. There is a need to keep a low threshold for the diagnosis of CeD in appropriate clinical settings. [ABSTRACT FROM AUTHOR]

Background: In cases of chronic otitis media (COM) presenting with unilateral squamosal disease, there may be the possibility of a potential disease in the opposite ear, which may lead to future complications. Therefore, it needs to be known whether there is any silent pathological process in the contralateral ear (CLE) that is currently asymptomatic but likely to be diseased in the near future. Therefore, this study was undertaken to analyze the fate of the contralateral asymptomatic ear in patients with unilateral squamosal disease. Results: A total of 32 patients with COM squamosal disease were included. All the patients were subjected to clinical examination and a high-resolution computed tomography (CT) scan of bilateral temporal bones. The mean duration of age at presentation was 20.4 years. The male-to-female ratio was 1.28. Out of 32 patients, 11 (34%) showed either clinical or radiological findings in the asymptomatic CLE, out of which 7 showed both abnormal clinical and radiological findings, 3 demonstrated only abnormal clinical findings, and 1 showed only abnormal CT changes without obvious clinical findings in the CLE. In the CLE, 7 (21%) patients had mild conductive hearing loss. There was no statistically significant association of clinical findings or radiological findings in CLE to that of the unilateral squamosal diseased ear. Conclusion: In cases with unilateral squamosal disease, an asymptomatic CLE can undergo subclinical changes and conductive hearing loss. Patients can also have silent radiological changes in the CLE detected on the CT scan, which are significant but remain undetected. No statistical significance could be reported in this study, yet other studies with even larger samples are required to show a causal relation between unilateral squamosal disease and a quiescent process in the asymptomatic CLE. [ABSTRACT FROM AUTHOR]