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Abstract Ensuring proper menstrual hygiene management remains a significant challenge for young women in India. The term "exclusive use of hygienic period products during menstruation" refers to relying solely on period products like sanitary pads, tampons, or menstrual cups. Poor menstrual hygiene practices not only increase the risk of reproductive tract infections but also lead to various negative health outcomes, including discomfort and potential complications. This study explores factors associated with the exclusive use of period products during menstruation aged 15–24, investigates geographic disparities, examines rural–urban gaps, and assesses inequality in India. Utilizing data from the fifth National Family Health Survey (NFHS-5), responses from 2,41,180 women aged 15 to 24 were analysed using logistic regression and multivariate decomposition analyses to explore socioeconomic predictors. Moran's I statistics also assessed spatial dependency, while Lorenz curves and Gini coefficients measured inequality. Quintile and LISA maps visualized regional disparities. The study found that 76.15% of women in India reported exclusive use of hygienic period products during menstruation. Rural areas reported a lower percentage of exclusive use of hygienic period products (72.32%) during menstruation compared to urban areas (89.37%). Key factors associated with the exclusive use of hygienic period products among 15–24-year-old women in India include age, education, place of residence, wealth, access to media, and healthcare discussions. Geographically, central districts exhibited the lowest coverage ( 85). The GINI coefficient of 0.39 highlighted moderate inequality in distribution. Decomposition analysis revealed that household wealth contributed 49.25% to rural–urban differences, followed by education (13.41%), media access (7.97%), and region (4.97%). This study highlights significant regional disparities and low utilization of hygienic period products among young women in India, particularly in central districts. Policymakers should prioritize interventions targeting these regions, addressing socio-economic disparities. Strategies to promote education, improve media access, and enhance household wealth can facilitate menstrual hygiene adoption. Initiatives to reduce sanitary napkin costs and increase accessibility, particularly in rural areas, are crucial to mitigating geographical disparities nationwide.

Abstract Near-field (NF) earthquakes have distinct ground motions, forward directivity pulses, and fling-step motions, causing structural responses to differ from far-field (FF) earthquakes. Seismic isolation is regarded as a developed and successful technology that may be applied to enhance a structure’s functionality and safeguard it against catastrophic earthquake effects. The variation in mechanical properties of seismic isolation also significantly influences bridge seismic response. The study investigates the influence of lead rubber (LRB) isolators and the characteristics of ground motions on seismically isolated bridges, aiming to determine optimal parameters for minimal earthquake response. Key parameters include ground motion characteristics, characteristic strength (Q), and isolator flexibility. The study modeled the force-deformation behavior of isolators using bilinear behavior, reflecting the Bouc-Wen hysteric model. CSI Bridge was used to model seismically isolated steel box girder bridges, with eight natural accelerograms assessing a 2% probability of exceedance in 50 years. The peak responses of pier displacement (MPD), isolator hysteric energy (HED), base shear, and deck acceleration are chosen as the response parameters for the comparison. To evaluate the response parameters, the earthquake data are scaled to the three studied peak ground acceleration (PGA) levels of design level (0.2 g), extreme level (0.4 g), and rare-extreme level (0.8 g). The findings offer insight on the relevance of isolator stiffness and its influences on the seismic performance of isolated bridges. The study identifies minimum values for pier displacement, hysteric energy, deck acceleration, and base shear at specific Q/weight sustained by isolator (W) and time period (T) values. Recommendations are made for the preliminary seismic isolation design of bridges with LRB isolators, highlighting the importance of PGV to PGA ratio in earthquake damage assessment.

Abstract Myocarditis is considered a fatal form of foot-and-mouth disease (FMD) in suckling calves. In the present study, a total of 17 calves under 4 months of age and suspected clinically for FMD were examined for clinical lesions, respiratory rate, heart rate, and heart rhythm. Lesion samples, saliva, nasal swabs, and whole blood were collected from suspected calves and subjected to Sandwich ELISA and reverse transcription multiplex polymerase chain reaction (RT-mPCR) for detection and serotyping of FMD virus (FMDV). The samples were found to be positive for FMDV serotype “O”. Myocarditis was suspected in 6 calves based on tachypnoea, tachycardia, and gallop rhythm. Serum aspartate aminotransferase (AST), creatinine kinase myocardial band (CK-MB) and lactate dehydrogenase (LDH), and cardiac troponins (cTnI) were measured. Mean serum AST, cTn-I and LDH were significantly higher (P 2 months 2 months

Introduction: Access to affordable and improved Water, Sanitation, and Hygiene (WASH) facilities is essential for people's daily lives, and it is the primary goal of Sustainable Development Goal 6 (SDG-6). However, achieving this goal is a significant challenge for many countries, including India. The aim of this study is to assess the progress made towards achieving SDG-6 targets in Indian districts, states, and Union Territories (UTs) and to identify clusters by measuring spatial inequality of WASH coverage in India. Aim and objective: The primary objective of this study is to measure the progress made towards achieving the SDG-6 targets for WASH facilities in Indian districts, states, and UTs. To fulfill this objective, the study used the household data of the National Family Health Survey-5 (NFHS-5) conducted from 2019 to 21. Data and methods: The study used the household data of NFHS-5, which is a nationally representative survey that provides information on household and individual-level characteristics related to health and nutrition. The study identified the variables associated with WASH and created a composite index to measure WASH coverage separately and combined. The study used Gini coefficient to show WASH inequality, and Moran's statistics were used to show spatial dependency. Result: The study found that the inequality of improved water coverage sources in Indian districts was high. Western and northeastern districts need to catch up in terms of achieving the SDG-6 targets. The value of the Gini coefficient (0.29) indicates that inequality in sanitation coverage is also high. All states have reached close to SDG-6 achievement in hygiene indicators. Goa, Sikkim, Andaman & Nicobar Islands, and Lakshadweep are close to the overall WASH coverage achievements of SDG-6. However, Jharkhand, Orissa, Tripura, Assam, and Rajasthan are behind in meeting the goal of SDG-6. Conclusion: The study suggests that more government initiatives and investments are needed to increase the availability, accessibility, and affordability of WASH facilities to improve WASH conditions in western and northeastern Indian districts. The localization or bottom-up approach by giving responsibility to rural and urban local bodies can also help enforce the achievement of SDG-6. The findings of this study can be used to guide policymakers in developing targeted interventions to improve WASH conditions and reduce inequality in India.

Objective: To identify highest-risk subgroups for COVID-19 and Long COVID(LC), particularly in contexts of influenza and cardiovascular disease(CVD). Methods: Using national, linked electronic health records for England (NHS England Secure Data Environment via CVD-COVID-UK/COVID-IMPACT Consortium), we studied individuals (of all ages) with COVID-19 and LC (2020-2023). We compared all-cause hospitalization and mortality by prior CVD, high CV risk, vaccination status (COVID-19/influenza), and CVD drugs, investigating impact of vaccination and CVD prevention using population preventable fractions. Results: Hospitalization and mortality were 15.3% and 2.0% among 17,373,850 individuals with COVID-19 (LC rate 1.3%), and 16.8% and 1.4% among 301,115 with LC. Adjusted risk of mortality and hospitalization were reduced with COVID-19 vaccination ≥ 2 doses(COVID-19:HR 0.36 and 0.69; LC:0.44 and 0.90). With influenza vaccination, mortality was reduced, but not hospitalization (COVID-19:0.86 and 1.01, and LC:0.72 and 1.05). Mortality and hospitalization were reduced by CVD prevention in those with CVD, e.g., anticoagulants- COVID:19:0.69 and 0.92; LC:0.59 and 0.88; lipid lowering- COVID-19:0.69 and 0.86; LC:0.68 and 0.90. COVID-19 vaccination averted 245044 of 321383 and 7586 of 8738 preventable deaths after COVID-19 and LC, respectively. Interpretation: Prior CVD and high CV risk are associated with increased hospitalization and mortality in COVID-19 and LC. Targeted COVID-19 vaccination and CVD prevention are priority interventions. Funding: NIHR. HDR UK.

Objective To explore the risk of a positive test result for the delta or omicron variant of the SARS-CoV-2 virus in different occupations and deprivation groups in the UK.Design Analysis of the longitudinal COVID-19 Infection Survey.Setting COVID-19 Infection Survey, conducted by the Office for National Statistics and the University of Oxford, UK, a nationwide longitudinal survey to monitor SARS-CoV-2 infection in the community, 26 April 2020 to 31 January 2022.Participants Survey participants recruited from randomly selected households to reflect the UK population (England, Scotland, Wales, and Northern Ireland) were divided into the delta cohort (2 July 2020 to 19 December 2021) and the omicron variant (on or after 20 December 2021), the dominant variants during our study period.Main outcome measures Incidence rate and incidence rate ratio for the presence of the delta and omicron variants by area level deprivation and occupation sector. Multivariable Poisson regression models were fitted to estimate the adjusted incidence rate ratio after adjusting for age, sex, ethnic group, comorbid conditions, urban or rural residence, household size, patient or client facing job, and time (as quarters of the year).Results 329 356 participants were included in the delta cohort and 246 061 in the omicron cohort. The crude incidence rate for the presence of the delta and omicron variants of the SARS-CoV-2 virus were higher in the most deprived group (based on the index of multiple deprivation divided by deciles; delta cohort 4.33 per 1000 person months, 95% confidence interval 4.09 to 4.58; omicron cohort 76.67 per 1000 person months, 71.60 to 82.11) than in the least deprived group (3.18, 3.05 to 3.31 and 54.52, 51.93 to 57.24, respectively); the corresponding adjusted incidence rate ratios were 1.37 (95% confidence interval 1.29 to 1.47) and 1.34 (1.24 to 1.46) during the delta and omicron variant dominant periods, respectively. The adjusted incidence rate ratios for a positive test result in the most deprived group compared with the least deprived group in the delta cohort were 1.59 (95% confidence interval 1.25 to 2.02) and 1.50 (1.19 to 1.87) in the healthcare and manufacturing or construction sectors, respectively. Corresponding values in the omicron cohort were 1.50 (1.15 to 1.95) and 1.43 (1.09 to 1.86) in the healthcare and teaching and education sectors, respectively. Associations between SARS-CoV-2 infection and other employment sectors were not significant or were not tested because of small numbers.Conclusion In this study, the risk of a positive test result for the SARS-CoV-2 virus in the delta and omicron cohorts was higher in the most deprived than in the least deprived group in the healthcare, manufacturing or construction, and teaching and education sectors.

Objectives To classify older adults into clusters based on accumulating long-term conditions (LTC) as trajectories, characterise clusters and quantify their associations with all-cause mortality.Design We conducted a longitudinal study using the English Longitudinal Study of Ageing over 9 years (n=15 091 aged 50 years and older). Group-based trajectory modelling was used to classify people into clusters based on accumulating LTC over time. Derived clusters were used to quantify the associations between trajectory memberships, sociodemographic characteristics and all-cause mortality by conducting regression models.Results Five distinct clusters of accumulating LTC trajectories were identified and characterised as: ‘no LTC’ (18.57%), ‘single LTC’ (31.21%), ‘evolving multimorbidity’ (25.82%), ‘moderate multimorbidity’ (17.12%) and ‘high multimorbidity’ (7.27%). Increasing age was consistently associated with a larger number of LTCs. Ethnic minorities (adjusted OR=2.04; 95% CI 1.40 to 3.00) were associated with the ‘high multimorbidity’ cluster. Higher education and paid employment were associated with a lower likelihood of progression over time towards an increased number of LTCs. All the clusters had higher all-cause mortality than the ‘no LTC’ cluster.Conclusions The development of multimorbidity in the number of conditions over time follows distinct trajectories. These are determined by non-modifiable (age, ethnicity) and modifiable factors (education and employment). Stratifying risk through clustering will enable practitioners to identify older adults with a higher likelihood of worsening LTC over time to tailor effective interventions to prevent mortality.

Ivermectin (IVM), a drug originally used for treating parasitic infections, is being explored for its potential applications in cancer therapy. Despite the promising anti-cancer effects of IVM, its low water solubility limits its bioavailability and, consequently, its biological efficacy as an oral formulation. To overcome this challenge, our research focused on developing IVM-loaded lipid polymer hybrid nanoparticles (LPHNPs) designed for potential pulmonary administration. IVM-loaded LPHNPs were developed using the emulsion solvent evaporation method and characterized in terms of particle size, morphology, entrapment efficiency, and release pattern. Solid phase characterization was investigated by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). Using a Twin stage impinger (TSI) attached to a device, aerosolization properties of the developed LPHNPs were studied at a flow rate of 60 L/min, and IVM was determined by a validated HPLC method. IVM-loaded LPHNPs demonstrated spherical-shaped particles between 302 and 350 nm. Developed formulations showed an entrapment efficiency between 68 and 80% and a sustained 50 to 60% IVM release pattern within 96 h. Carr’s index (CI), Hausner ratio (HR), and angle of repose (θ) indicated proper flowability of the fabricated LPHNPs. The in vitro aerosolization analysis revealed fine particle fractions (FPFs) ranging from 18.53% to 24.77%. This in vitro study demonstrates the potential of IVM-loaded LPHNPs as a delivery vehicle through the pulmonary route.

Introduction Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain.Methods and analysis A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews.Ethics approval and dissemination Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country.Trial registration number ISRCTN18010240.

Background Hyperbilirubinemia is a common issue in neonates, with jaundice affecting a significant proportion of both term and preterm infants. While most cases of neonatal jaundice are benign, a subset requires intervention. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a notable cause of pathological jaundice that can lead to severe hyperbilirubinemia and neurological complications. So, this study aimed to determine the prevalence of G6PD deficiency among neonates with severe hyperbilirubinemia.

In this research article, Diels-Alder (DA) reaction triggered self-healing of epoxy polymer-based nanocomposites has been demonstrated by surface functionalization of graphitic nanoplatelets (GNPs) with thermo-reversible bismaleimide (BMI). The flexural properties of the DA based self-healing polymers are very poor due to brittle matrix which has been improved by using functionalized graphene along with healing efficiency. The self-healing hybrid matrix of the polymer composites were synthesized by adding thermo-reversible bismaleimide resin in thermo-irreversible epoxy resin to gain both flexural properties and healing performance. The surface functionalization of the GNPs was confirmed from transmission electron microscope (TEM). The thermal property of the hybrid matrix confirmed from thermo-gravimetric analysis (TGA) and molecular architecture of the GNPs were confirmed from Fourier Transform Infra-red Spectroscopy (FTIR), respectively. The flexural properties of the composites were found to be increased by ∼21% and maximum healing efficiency was observed as ∼75% due to incorporation of the functionalized GNPs. Thus, this work demonstrates for the first time an innovative method to improve mechanical and healing efficiency of the nanocomposites.

Summary: Background: Chronic cough is a common respiratory symptom with an impact on daily activities and quality of life. Global prevalence data are scarce and derive mainly from European and Asian countries and studies with outcomes other than chronic cough. In this study, we aimed to estimate the prevalence of chronic cough across a large number of study sites as well as to identify its main risk factors using a standardised protocol and definition. Methods: We analysed cross-sectional data from 33,983 adults (≥40 years), recruited between Jan 2, 2003 and Dec 26, 2016, in 41 sites (34 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We estimated the prevalence of chronic cough for each site accounting for sampling design. To identify risk factors, we conducted multivariable logistic regression analysis within each site and then pooled estimates using random-effects meta-analysis. We also calculated the population attributable risk (PAR) associated with each of the identifed risk factors. Findings: The prevalence of chronic cough varied from 3% in India (rural Pune) to 24% in the United States of America (Lexington,KY). Chronic cough was more common among females, both current and passive smokers, those working in a dusty job, those with a history of tuberculosis, those who were obese, those with a low level of education and those with hypertension or airflow limitation. The most influential risk factors were current smoking and working in a dusty job. Interpretation: Our findings suggested that the prevalence of chronic cough varies widely across sites in different world regions. Cigarette smoking and exposure to dust in the workplace are its major risk factors. Funding: Wellcome Trust.

Abstract During the COVID-19 pandemic, the gap in health inequities was exposed and increased, showing how different vulnerable groups were affected. Our aim was to examine the correlation between an area-based health inequity index and mortality due to COVID-19 in people 60 years old or above in the City of Buenos Aires in 2020. We developed a Health Inequity Composite Index (HICI), including six core indicators. Each indicator value per Comuna was first standardized to a Z-score. All six Z-scores were summed into a final composite Z-score to rank the Comunas from lowest to highest social inequities. Comunas from the northern part of the city had lower inequities whereas those in the south had higher levels of inequities. COVID-19 age-standardized mortality rate in people 60 years or above was higher in the Comunas from the south and lower in those from the north. Finally, we found a strong positive correlation (Rho = 0.83, p

Abstract The Cenozoic-age Makum coal from northeastern India offers numerous research opportunities because of its diverse geochemical and geological characteristics. Due to its high sulfur content, the coal has been found to be less useful for industrial purposes. It can, however, serve as a hub for ongoing research on coal-based derivative products. The aim of this research work is to investigate the mineralogical and geochemical compositions of the coal, mine overburden (MOB) and shale samples taken from the Makum coal field and also on establishing a mutual relationship between them. To characterize the geochemical controlling factors of the Makum coal field, the study employs coal petrography, FTIR, mineralogical, and geochemical analysis. According to X-ray diffraction analysis, the major minerals like quartz, kaolinite, haematite, illite, pyrite, and calcite are present in coal and MOB. Pyrite is observed by SEM–EDS analysis as cubic-shaped particles that are smaller than a few µm in size. The presence of sulfide minerals represents a phase of pyrite mineralization. The petrography study was used to better understand the environment that existed during the formation of the plant material, which aids us in determining the quantity of detrital mineral sediment contained in the coal. According to the ICP-MS analysis, the samples indicate significant levels of rare earth elements including yttrium. The present study reveals higher concentrations of potential hazardous elements in the coal samples, with V, Cr, Ni, Cu, and Zn content in coal being considerably enriched compared to world-average concentrations. The correlation analysis reveals that the potential hazardous elements like Co, Ni, As, and Cu are associated with pyrite as they have strong affinity towards pyrite. Thus, numerous minerals and rare earth elements (REEs) exist, opening up a fresh avenue for more research in the area. This study also assists researchers in understanding the significance of Makum coal and provides numerous ideas for coal characterization.

Abstract Background The role of fatty acids in coronary heart disease (CHD) remains uncertain. There is little evidence from large-scale epidemiological studies on the relevance of circulating fatty acids levels to CHD risk. This study aims to examine the independent associations of the major circulating types of fatty acids with CHD risk. Methods UK Biobank is a prospective study of adults aged 40–69 in 2006–2010; in 2012–2013, a subset of the participants were resurveyed. Analyses were restricted to 89,242 participants with baseline plasma fatty acids (measured using nuclear magnetic resonance spectroscopy) and without prior CHD. Cox proportional hazards models were used to estimate hazard ratios (HRs) for the associations with incidence CHD, defined as the first-ever myocardial infarction, unstable angina pectoris, coronary-related death, or relevant procedure. And the major types of fatty acids were mutually adjusted to examine the independent associations. Hazard ratios were corrected for regression dilution using the correlation of baseline and resurvey fatty acids measures. Results During a median follow-up of 11.8 years, 3,815 incident cases of CHD occurred. Independently of other fatty acids, CHD risk was positively associated with saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA), inversely associated with omega-3 polyunsaturated fatty acids (PUFA), but there was no strong evidence of an association with omega-6 PUFA: HR per standard deviation higher were 1.14 (95% CI, 1.09–1.20), 1.15 (1.10–1.21), 0.91 (0.87–0.94), and 1.04 (0.99–1.09) respectively. Independently of triglycerides and cholesterol, the inverse association with omega-3 PUFA was not materially changed, but the positive associations with SFA and MUFA attenuated to null after adjusting for triglycerides levels. Conclusions This large-scale study has quantitated the independent associations of circulating fatty acids with CHD risk. Omega-3 PUFA was inversely related to CHD risk, independently of other fatty acids and major lipid fractions. By contrast, independently of other fatty acids, the positive associations of circulating SFA and MUFA with CHD risk were mostly attributed to their relationship with triglycerides.

Inhaled ciprofloxacin (CFX) has been investigated as a treatment for lower respiratory tract infections (LRTIs) associated with cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), and bronchiectasis. The challenges in CFX effectiveness for LRTI treatment include poor aqueous solubility and therapy resistance. CFX dry powder for inhalation (DPI) formulations were well-tolerated, showing a remarkable decline in overall bacterial burden compared to a placebo in bronchiectasis patients. Recent research using an inhalable powder combining Pseudomonas phage PEV20 with CFX exhibited a substantial reduction in bacterial density in mouse lungs infected with clinical P. aeruginosa strains and reduced inflammation. Currently, studies suggest that elevated biosynthesis of fatty acids could serve as a potential biomarker for detecting CFX resistance in LRTIs. Furthermore, inhaled CFX has successfully addressed various challenges associated with traditional CFX, including the incapacity to eliminate the pathogen, the recurrence of colonization, and the development of resistance. However, further exploration is needed to address three key unresolved issues: identifying the right patient group, determining the optimal treatment duration, and accurately assessing the risk of antibiotic resistance, with additional multicenter randomized controlled trials suggested to tackle these challenges. Importantly, future investigations will focus on the effectiveness of CFX DPI in bronchiectasis and COPD, aiming to differentiate prognoses between these two conditions. This review underscores the importance of CFX inhalable formulations against LRTIs in preclinical and clinical sectors, their challenges, recent advancements, and future perspectives.

The energy crisis forced the world to look for alternate energy solutions. Amongst these, solar energy is the first choice of scientists that convert solar radiation into heat or electricity to meet the energy deficit. Despite its marginally high installation cost, this renewable energy solution is long-lasting with minimum operating cost. Heading in the same direction, the attributes of the solar radiation towards the heat transfer rate of hybrid nanocomposite comprising paraffin wax amalgamated with copper-oxide, and cobalt-oxide (CuO-Co3O4) nanocomposites and thin-film spraying over an inclined rotating disk are discussed. The nanocomposites are considered in varied shapes. The model is supported by the Arrhenius activation energy in the concentration equation and the convective boundary condition at the surface. The model assumptions are translated into the system of partial differential equations which are then converted into differential equations with apposite similarity transformations. The numerical solution of the transformed system is obtained by the Keller box method. The obtained results are analyzed graphically. The maximum heat transfer rate is witnessed in the case of spherical-shaped particles. Furthermore, the hybrid nanocomposite fluid velocity is augmented when the width of the film is improved.

Introduction Despite a growing body of scholarly research on the risks of severe COVID-19 associated with diabetes, hypertension and obesity, there is a need for estimating pooled risk estimates with adjustment for confounding effects. We conducted a systematic review and meta-analysis to estimate the pooled adjusted risk ratios of diabetes, hypertension and obesity on COVID-19 mortality.Methods We searched 16 literature databases for original studies published between 1 December 2019 and 31 December 2020. We used the adapted Newcastle-Ottawa Scale to assess the risk of bias. Pooled risk ratios were estimated based on the adjusted effect sizes. We applied random-effects meta-analysis to account for the uncertainty in residual heterogeneity. We used contour-funnel plots and Egger’s test to assess possible publication bias.Results We reviewed 34 830 records identified in literature search, of which 145 original studies were included in the meta-analysis. Pooled adjusted risk ratios were 1.43 (95% CI 1.32 to 1.54), 1.19 (95% CI 1.09 to 1.30) and 1.39 (95% CI 1.27 to 1.52) for diabetes, hypertension and obesity (body mass index ≥30 kg/m2) on COVID-19 mortality, respectively. The pooled adjusted risk ratios appeared to be stronger in studies conducted before April 2020, Western Pacific Region, low- and middle-income countries, and countries with low Global Health Security Index scores, when compared with their counterparts.Conclusions Diabetes, hypertension and obesity were associated with an increased risk of COVID-19 mortality independent of other known risk factors, particularly in low-resource settings. Addressing these chronic diseases could be important for global pandemic preparedness and mortality prevention.PROSPERO registration number CRD42021204371.

BackgroundTyphoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid. Hence, with rising drug resistance in Salmonella Typhi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. However, unlike for typhoid, there is no vaccine to prevent paratyphoid. Here, we report 23-year AMR trends of Salmonella Paratyphi A in Bangladesh.MethodsFrom 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines.ResultsOver 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but the current average MIC is 32-fold lower than the resistance cut-off. Over 99% of the isolates exhibited decreased susceptibility to ciprofloxacin.ConclusionsSalmonella Paratyphi A has remained susceptible to most antibiotics, unlike Salmonella Typhi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever, especially in the post typhoid vaccine era, and with the availability of new paratyphoid diagnostics.

Background Associations of coronary heart disease (CHD) with plasma lipids are well described, but the associations with characteristics of lipoproteins (which transport lipids) remain unclear. Methods and Results UK Biobank is a prospective study of 0.5 million adults. Analyses were restricted to 89 422 participants with plasma lipoprotein and apolipoprotein measures from Nightingale nuclear magnetic resonance spectroscopy and without CHD at baseline. CHD risk was positively associated with concentrations of very‐low‐density lipoproteins, intermediate‐density lipoproteins, and low‐density lipoproteins (LDL), and inversely associated with high‐density lipoproteins. Hazard ratios (99% CIs) per SD were 1.22 (1.17–1.28), 1.16 (1.11–1.21), 1.20 (1.15–1.25), and 0.90 (0.86–0.95), respectively. Larger subclasses of very‐low‐density lipoproteins were less strongly associated with CHD risk, but associations did not materially vary by size of LDL or high‐density lipoprotein. Given lipoprotein particle concentrations, lipid composition (including cholesterol) was not strongly related to CHD risk, except for triglyceride in LDL particles. Apolipoprotein B was highly correlated with LDL concentration (r=0.99), but after adjustment for apolipoprotein B, concentrations of very‐low‐density lipoprotein and high‐density lipoprotein particles remained strongly related to CHD risk. Conclusions This large‐scale study reliably quantifies the associations of nuclear magnetic resonance–defined lipoprotein characteristics with CHD risk. CHD risk was most strongly related to particle concentrations, and separate measurements of lipoprotein concentrations may be of greater value than the measurement by apolipoprotein B, which was largely determined by LDL concentration alone. Furthermore, there was strong evidence of positive association with mean triglyceride molecules per LDL particle but little evidence of associations with total triglycerides or other lipid and lipoprotein fractions after accounting for lipoprotein concentrations.

The carbon nanotubes (CNTs) possess unique properties due to their structural mechanism. The CNTs comprise of exceptional electrical, mechanical and thermal attributes. This paper aims to interpret the correlation of carbon nanotube nanoparticles with motile microorganisms in a rotating magnetohydrodynamic flow with respect to slip as well as convective boundary conditions. Multi-wall carbon nanotubes (MWCNTs) are incorporated as nanoparticles whereas water (H2O) as host fluid. The dimension free appearance of governing differential equations is caused by the similarity transformation. Afterward, the combination of order reduction and finite differences is used to determine the approximate solution of the problem. The consequences of problem parameters for temperature, velocity, Nusselt number and skin friction are deliberated through tables and graphs. The code efficiency is assessed by equating the results, under limiting cases, with the previous ones and found to be in an exceptional agreement. The temperature seems to be elevating with the influence of Biot number. On the other hand, a decreasing trend in the velocity profile is noticed when we increase the parametric values of rotation as well as slip parameter. The Peclet number is one of the factor that reduces the microbe's density distribution within the boundary layer regions.

Abstract Remarkable advancement in wave energy conversion technology has taken place in recent years. Due to its simplicity, the Wells turbine has been one of the most widely used power take-off mechanisms in an oscillating water column type wave-energy conversion device. However, the turbine suffers from several challenges due to its narrow operating range, which hinders the commercial feasibility of the system. Several aerodynamic applications have successfully used passive control methods to modify the flow conditions. This work applied a combination of stall fences and casing grooves for passive flow control of a Wells turbine. The computational fluid dynamics (CFD) technique is used to analyze the modified turbine numerically. The casing groove modified the tip-leakage vortices, interacted with local vortices created by the stall fences, and helped reattach the flow at higher flow coefficients. As a result, the modified turbine increases the operating range up to 33.3%. In addition, the peak-to-average (PTA) power ratio decreased by up to 27.7%.

PURPOSE: The global COVID-19 pandemic has profoundly impacted multiple sectors across industries and regions, including medical services, financial institutions, and others. The escalating global pandemic in both emerging and developed nations has resulted in the implementation of stringent lockdown measures and unparalleled disruptions to economic activities. Consequently, individuals have become accustomed to relying on banking operations as a routine aspect of their lives, regardless of the circumstances. Learning how bankers engage with customers in response to the given circumstances would be intriguing. Hence, the study aimed to unearth the relationship between bankers’ job stress, job performance, and job commitment, as well as the stress-based job performance and its impact on job commitment during the second to third wave of the COVID-19 pandemic in an emerging market. METHODOLOGY: A number of 287 data (response rate 71.75 percent) were collected by online platforms due to the COVID-19 pandemic through the simple random sampling technique. The exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were run to test the proposed research framework with the help of MS Excel 2007, SPSS 22.0, and AMOS 23.0. FINDINGS: The findings showed that bankers’ work-related stress has a positive impact on job performance but no relationship with job commitment; acute stress has a negative impact on job commitment but no significant relationship with job performance; and stress-based job performance has a significant positive impact on job commitment during the COVID-19 pandemic. IMPLICATIONS: The outcomes of this study provide value to the field of behavioral science by introducing the phenomena of COVID-19 in the context of bankers and emerging economies. The demographic variables and the revealed relationships of bankers’ job stress, job performance, and job commitment trajectories would help policymakers rethink stress management practices and policy building in the bank job and the long-term relationship building with their existing employees. ORIGINALITY AND VALUE: The novelty of the research is the COVID-19 phenomenon and an emerging economy’s bankers’ context.

Abstract Background Ethnic minority groups in England have been disproportionately affected by the COVID-19 pandemic and have lower vaccination rates than the White British population. We examined whether ethnic differences in COVID-19 mortality in England have continued since the vaccine rollout and to what extent differences in vaccination rates contributed to excess COVID-19 mortality after accounting for other risk factors. Methods We conducted a retrospective, population-based cohort study of 28.8 million adults aged 30–100 years in England. Self-reported ethnicity was obtained from the 2011 Census. The outcome was death involving COVID-19 during the second (8 December 2020 to 12 June 2021) and third wave (13 June 2021 to 1 December 2021). We calculated hazard ratios (HRs) for death involving COVID-19, sequentially adjusting for age, residence type, geographical factors, sociodemographic characteristics, pre-pandemic health, and vaccination status. Results Age-adjusted HRs of death involving COVID-19 were elevated for most ethnic minority groups during both waves, particularly for groups with lowest vaccination rates (Bangladeshi, Pakistani, Black African, and Black Caribbean). HRs were attenuated after adjusting for geographical factors, sociodemographic characteristics, and pre-pandemic health. Further adjusting for vaccination status substantially reduced residual HRs for Black African, Black Caribbean, and Pakistani groups in the third wave. Fully adjusted HRs only remained elevated for the Bangladeshi group (men: 2.19 [95% CI 1.72–2.78]; women: 2.12 [1.58–2.86]) and Pakistani men (1.24 [1.06–1.46]). Conclusions Lower COVID-19 vaccination uptake in several ethnic minority groups may drive some of the differences in COVID-19 mortality compared to White British. Public health strategies to increase vaccination uptake in ethnic minority groups would help reduce inequalities in COVID-19 mortality, which have remained substantial since the start of the vaccination campaign.

Dynamic solar photovoltaic (PV) greenhouses combine the concept of agriculture with sustainable energy production. By varying sun-tracking angles, they provide greater energy production and microclimate control opportunities. Previous research on PV greenhouses rarely considered the impacts of partial shading and documented the performance over the entire range of rotation angles. This paper provides a fully documented copy of the performance of dynamic solar trackers over the day and proposes a cost-efficient model. The proposed model in this paper will reduce the generation of greenhouse gasses and eventually will participate in preventing global warming by producing clean energy, which is an eco-friendly solution to peak energy demand. Excess power can be sold to the state grid, and revenue can be generated. The model is designed using Proteus 8 professional platform and implemented practically, without using any micro-controller, to test its performance. According to the results, no-shading sun tracking produces about 20% more energy than conventional fixed PV which is highly economical. The proposed model will reduce about 50-60% cost than the existing models which will be highly beneficial.

Recent research has shown that antibiotic-resistant microorganisms are becoming more prevalent in intensive care units (ICUs) at an exponential rate. Patients in the ICU can get infected by pathogens due to invasive operation procedures and critical health conditions. This study primarily emphasized tracheal samples from ICU patients due to their reliance on ventilators, increasing their susceptibility to Ventilator-Associated Pneumonia (VAP). Moreover, the rise of multidrug-resistant (MDR) pathogens makes treatment strategies more challenging for these patients. In this study, we tested 200 tracheal specimens to determine the prevalence of microorganisms and analyzed the antibiotic susceptibility of these isolates against regular antibiotics, including 4th generation drugs. Among the 273 isolates, 81% were gram-negative bacteria, 10% were gram-positive bacteria, and 9% were fungi. The most prevalent gram-negative bacteria were Acinetobacter spp. (34%), Klebsiella spp. (22%), Pseudomonas spp. (14%), and Escherichia coli (9.2%). The most prevalent gram-positive bacteria were Staphylococcus aureus (5.9%), and the fungi were Candida spp. (7.3%). Among the most prevalent bacteria, except Staphylococcus aureus isolates, around 90% were resistant to multiple drugs, whereas 60% of Acinetobacter spp. and Pseudomonas spp. were extensively drug resistant. Sensitivity analysis against the gram-negative and gram-positive drug panel using a one-way ANOVA test followed by Tukey’s post hoc test showed that in the in vitro assay, colistin was the most effective antibiotic against all gram-negative bacteria. In contrast, linezolid, vancomycin, and fusidic acid were most effective against all gram-positive bacteria. Regular monitoring of nosocomial infections and safe management of highly resistant bacteria can help prevent future pandemics.

Background Observational studies are increasingly used to inform health decision-making when randomised trials are not feasible, ethical or timely. The target trial approach provides a framework to help minimise common biases in observational studies that aim to estimate the causal effect of interventions. Incomplete reporting of studies using the target trial framework limits the ability for clinicians, researchers, patients and other decision-makers to appraise, synthesise and interpret findings to inform clinical and public health practice and policy. This paper describes the methods that we will use to develop the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) reporting guideline.Methods/design The TARGET reporting guideline will be developed in five stages following recommended guidance. The first stage will identify target trial reporting practices by systematically reviewing published studies that explicitly emulated a target trial. The second stage will identify and refine items to be considered for inclusion in the TARGET guideline by consulting content experts using sequential online surveys. The third stage will prioritise and consolidate key items to be included in the TARGET guideline at an in-person consensus meeting of TARGET investigators. The fourth stage will produce and pilot-test both the TARGET guideline and explanation and elaboration document with relevant stakeholders. The fifth stage will disseminate the TARGET guideline and resources via journals, conferences and courses.Ethics and dissemination Ethical approval for the survey has been attained (HC220536). The TARGET guideline will be disseminated widely in partnership with stakeholders to maximise adoption and improve reporting of these studies.

Background The aim of this systematic review was to quantify the associations between body composition measures and risk of incident heart failure (HF) and its subtypes in the general population. Methods and Results We searched Medline, Embase, and Global Health databases from each database inception to January 19, 2023 for prospective studies reporting on body composition and HF risk. We followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The Newcastle‐Ottawa scale was used to assess the risk of bias of included studies. Fixed‐effects models were used for meta‐analysis. Thirty‐five studies were included (ntotal=1 137 044; ncases=34 422). Summary relative risk (RR) per 5‐kg/m2 higher body mass index was 1.42 (95% CI, 1.40–1.42; 𝜁2=0.02, I2=94.4%), 1.28 (95% CI, 1.26–1.31; 𝜁2=0.01, I2=75.8%) per 10‐cm higher waist circumference, and 1.33 (95% CI, 1.28–1.37; 𝜁2=0.04, I2=94.9%) per 0.1‐unit higher waist–hip ratio. Pooled estimates of the few studies that reported on regional fat suggested significant positive association between HF risk and both visceral fat (RR, 1.08 [95% CI, 1.04–1.12]) and pericardial fat (RR, 1.08 [95% CI, 1.06–1.10]). Among HF subtypes, associations were stronger for HF with preserved ejection fraction than HF with reduced ejection fraction. No study reported on lean mass. Conclusions Pooled data suggested strong associations between adiposity and HF. The association with adiposity is stronger for HF with preserved ejection fraction than HF with reduced ejection fraction, indicating that different mechanisms may be at play in etiopathogenesis of HF subtypes. Future studies are needed to investigate role of regional fat mass and lean mass in HF risk. Registration Information REGISTRATION: URL: www.crd.york.ac.uk/prospero/. Unique identifier: CRD42020224584.

Ethanol and biodiesel, which both belong to the first generation of biofuel technology, are the two most popular forms of biofuels now in use. In order to create next-generation biofuels using waste, cellulosic biomass, and algae-based resources, the Bioenergy Technologies Office (BETO) is working with business. The present article is designed to study the effect of tetra hybrid nanoparticles with the utilization of the novel Hamilton and Crosser model and catalytic reaction on binary fluid with the consideration of ethanol biofuel as a base fluid. Ethanol comprising tetra hybrid nanoparticles and heterogeneous catalytic reaction amplifies thermal conductivity and significantly increases brake thermal efficiency and reduces brake-specific fuel consumption in diesel engines. Therefore, the aim of this article is a theoretical checkup that is related to heat and mass transport of biofuel flow considering binary fluid accompanied with autocatalysis reaction and novel tetra hybrid nanoparticles on biofluid flow subjected to a Riga wedge. Transportation of heat via nonuniform heat source/sink, thermal radiation, and thermal conductivity are in our consideration. The mathematics of the assumed problem generates the system of non-linear partial differential equations from basic equations of momentum, energy, and mass. The usage of non-dimensional variables gave a system of non-linear ODEs with boundary conditions which are further dealt with in the Lobatto111A scheme. The results are obtained for stretching/shrinking wedge with several parameters. From obtained results, it is observed that the velocity field diminishes owing to magnification in Weissenberg number and Casson fluid parameter. The temperature field diminishes by amplifying heat generation, thermal radiation, and variable thermal conductivity parameter. Concentration distribution escalates by rising homogeneous reaction parameters.

Estimating water quality has been one of the significant challenges faced by the world in recent decades. This paper presents a water quality prediction model utilizing the principal component regression technique. Firstly, the water quality index (WQI) is calculated using the weighted arithmetic index method. Secondly, the principal component analysis (PCA) is applied to the dataset, and the most dominant WQI parameters have been extracted. Thirdly, to predict the WQI, different regression algorithms are used to the PCA output. Finally, the Gradient Boosting Classifier is utilized to classify the water quality status. The proposed system is experimentally evaluated on a Gulshan Lake-related dataset. The results demonstrate 95% prediction accuracy for the principal component regression method and 100% classification accuracy for the Gradient Boosting Classifier method, which show credible performance compared with the state-of-art models.

The control of light in photonic crystal fiber (PCF) is a special characteristic that is obtained due to the relations between material and light. In this paper, a surface plasmon resonance (SPR) based PCF sensor is introduced with two open-channel which cover an extensive field of bio-detection applications. Gold (Au) is considered as an effective plasmonic ingredient. The transformation of light through the fiber core is coupled with the gold and stimulates SPR. The proposed PCF-SPR sensor reports the highest wavelength sensitivity (WS) of 7000 nm/RIU (refractive index unit) as well as an amplitude sensitivity (AS) of 593.61 RIU−1. It also acquires an increased sensor resolution of 1.43 × 10−5 RIU and a decent figure of merit (FOM) is 94.97 RIU−1. Additionally, the operating constraints of the sensor such as corresponding air-holes diameter, the pitch, gold layer (Au) thickness and open-channel radius are revised to improve detection performance. The overall measurement is carried out over a broad range of variations in refractive index (RI) from 1.33 to 1.40. The sensor's appreciable performance makes it suitable for bio-sensing applications.

The gastrointestinal polyp (GIP) is the abnormal growth of tissues in digestive organs. Identifying these polyps from endoscopy video or image is a tremendous task to reduce the future risk of gastrointestinal cancer. This paper proposes a proper diagnosis method of polyp using a fusion of contourlet transform and fine-tuned VGG19 pre-trained model from enhanced endoscopic 224 × 224 patch images. This study has used different fine-tuned models (Alexnet, ResNet50, VGG16, VGG19) as well as a few scratch models while fine-tuned VGG19 works better. Also, this research has used Principal Component Analysis (PCA) and Minimum Redundancy Maximum Relevance (MRMR) dimensionality reduction methods to collect the intuitive features for classification. In Support Vector Machine (SVM) based polyp detection, the prior method (PCA) performs better. Besides, a proposed algorithm marks polyp region from identified polyp patches and uses a binning strategy to process video. A set of experiments are performed on standard public data sets and found comparative improved performance with an accuracy of 99.59%, sensitivity of 99.74% and specificity of 99.44%. This work can be instrumental for the radiologist for diagnosis of polyps during real-time endoscopy.

Obesity is a known risk factor for severe COVID-19 disease. Here, the authors use linked Census, electronic health records, and mortality data for 12.6 million adults in England and show that the association between COVID-19 mortality and body mass index is stronger in ethnic minority groups.

Abstract Background There is a need to develop cost-effective weight loss maintenance interventions to prolong the positive impact of weight loss on health outcomes. Conducting pre-trial health economic modelling is recommended to inform the design and development of behavioural interventions. We aimed to use health economic modelling to estimate the maximum cost per-person (justifiable cost) of a cost-effective behavioural weight loss maintenance intervention, given an estimated intervention effect for individuals with: i) a Body Mass Index (BMI) of 28 kg/m2 or above without diabetes and ii) a diagnosis of type 2 diabetes prescribed a single non-insulin diabetes medication. Methods The School for Public Health Research Diabetes prevention model was used to estimate the lifetime Quality-adjusted life year (QALY) gains, healthcare costs, and maximum justifiable cost associated with a weight loss maintenance intervention. Based on a meta-analysis, the estimated effect of a weight loss maintenance intervention following a 9 kg weight loss, was a regain of 1.33 kg and 4.38 kg in years one and two respectively compared to greater regain of 2.84 kg and 5.6 kg in the control group. Sensitivity analysis was conducted around the rate of regain, duration of effect and initial weight loss. Results The justifiable cost for a weight loss maintenance intervention at an ICER of £20,000 per QALY was £104.64 for an individual with a BMI of 28 or over and £88.14 for an individual with type 2 diabetes. Within sensitivity analysis, this varied from £36.42 to £203.77 for the former, and between £29.98 and £173.05 for the latter. Conclusions Researchers developing a weight loss maintenance intervention should consider these maximum justifiable cost estimates and the potential impact of the duration of effect and initial weight loss when designing intervention content and deciding target populations. Future research should consider using the methods demonstrated in this study to use health economic modelling to inform the design and budgetary decisions in the development of a behavioural interventions.

Biologically inspired autonomous underwater vehicles (AUVs) or biomimetic AUVs are made to replicate the structural and physiological features of aquatic species. Thus, incorporation of its design in AUV modelling provides higher efficiency at low speeds and improves maneuverability and controllability. This paper develops a biomimetic AUV design based on structural parameters and physiology of an adult Atlantic Salmon fish and proposes a robust control scheme for propelling the fins. For the biomimetic model design of AUV, a 3D CAD model is developed using the actual parameters of Atlantic Salmon fish. The hydrodynamic analysis is performed to calculate the effect of different angles of fin orientations on the value of drag and lift coefficients. Further, kinematic analysis of the tail propulsion system is carried out using the Denavit Hartenberg convention in the MATLAB®. Based on the obtained modeling parameters of AUV, a robust sliding mode controller is proposed for tracking the desired tail propulsion response using a DC motor under model uncertainties and disturbances. Moreover, the closed-loop asymptotic stability is also guaranteed through Lyapunov theory, which ensures the convergence of system states to the desired angular movement. Lastly, the proposed algorithm is validated using simulation results with comparative performance analysis to illustrate its efficacy.

Objective: To quantify the association between accelerometer-assessed physical activity and coronavirus disease 2019 (COVID-19) outcomes. Methods: Data from 82,253 UK Biobank participants with accelerometer data (measured 2013-2015), complete covariate data, and linked COVID-19 data from March 16, 2020, to March 16, 2021, were included. Two outcomes were investigated: severe COVID-19 (positive test result from in-hospital setting or COVID-19 as primary cause of death) and nonsevere COVID-19 (positive test result from community setting). Logistic regressions were used to assess associations with moderate to vigorous physical activity (MVPA), total activity, and intensity gradient. A higher intensity gradient indicates a higher proportion of vigorous activity. Results: Average MVPA was 48.1 (32.7) min/d. Physical activity was associated with lower odds of severe COVID-19 (adjusted odds ratio per standard deviation increase: MVPA, 0.75 [95% CI, 0.67 to 0.85]; total, 0.83 [0.74 to 0.92]; intensity, 0.77 [0.70 to 0.86]), with stronger associations in women (MVPA, 0.63 [0.52 to 0.77]; total, 0.76 [0.64 to 0.90]; intensity, 0.63 [0.53 to 0.74]) than in men (MVPA, 0.84 [0.73 to 0.97]; total, 0.88 [0.77 to 1.01]; intensity, 0.88 [0.77 to 1.00]). In contrast, when mutually adjusted, total activity was associated with higher odds of a nonsevere infection (1.10 [1.04 to 1.16]), whereas the intensity gradient was associated with lower odds (0.91 [0.86 to 0.97]). Conclusion: Odds of severe COVID-19 were approximately 25% lower per standard deviation (∼30 min/d) MVPA. A greater proportion of vigorous activity was associated with lower odds of severe and nonsevere infections. The association between total activity and higher odds of a nonsevere infection may be through greater community engagement and thus more exposure to the virus. Results support calls for public health messaging highlighting the potential of MVPA for reducing the odds of severe COVID-19.

Several different approaches are implemented and used to solve higher order non-linear boundary value problems (BVPs). Galerkin weighted residual technique (GWRT) are commonly used to solve linear and non-linear BVPs. In this paper, we have proposed GWRT for the numerical computations of general third order three-point non-linear BVPs. Modified Legendre and Bezier Polynomials, over the interval [0, 1], are chosen separately as a basis functions. The main advantage of this method is its efficiency and simple applicability. Numerical result is presented to illustrate the performance of the proposed method. The results clearly show that the proposed method is suitable for solving third order nonlinear BVPs

Sequestration of blue carbon (C) in mangrove plantations depends on site characteristics and plantation management. This study evaluated the effects of plantation management on C sequestration at a C-neutral site in Xiamen, China. A field study was conducted on 10-year-old Sonneratia apetala and Kandelia obovata plantations (mono-Sa, mono-Ko) and a 15-year-old mixed plantation-. We found that mono-Ko had a significantly higher ecosystem C sequestration rate (3.32 ± 0.62 kg C m−2 yr−1) than others when planted in the indirect shade of pioneer species. As a non-native species, Sonneratia performed better (0.57 ± 0.01 kg C m−2 yr−1) when planted with Kandelia than in monotypic plantations. The temporary and long-term certified emission reduction (tCER and lCER) of the 12.98 ha mono-Ko was 4103.89 and 3693.50 net CO2-e within 10 years, respectively. A literature review was conducted to show the compatibility of this study with other natural and plantation sites of China and Bangladesh (the native habitat for Sonneratia). The C sequestration of Sonneratia plantation sites in China is comparable with those in Bangladesh. However, the soil C accumulation rate for a Sonneratia monotypic plantation in Bangladesh decreased with age, yet the same did not occur in the plantations of China.

The current study addresses the features of entropy generation and thermal flows regarding magnetized hybrid nanofluid in the presence of a cylinder in a closed hexagonal domain. The hexagonal cavity comprises two heated horizontal walls, and two are insulated while the other walls are cold. The whole system has been modeled as coupled non-linear partial differential equations. Also, normalized the governing coupled equation by utilizing a proper pair of variables and are computed with a finite element approach. For the approximation of velocity profiles, a finite element space involving the quadratic polynomial (P2) is selected whereas the pressure and temperature estimation is accomplished through a space of linear polynomial (P1). An analogy is handed with published findings at confining instance. The degree of freedom and grid convergence test is considered for the kinetic energy (KE) and Bejan number (Be). The study reveals a major role in enhancing the heat transfer rate due to hybrid nano-particles. The results show that the increase of magnetic field effect considers the reduction of the heat transfer because the conduction motion occupies the motion of the fluid flow. When the Hartmann number is increased, the magnetic entropy is raised, too. For intensified the Hartmann numbers, the highest ratio of heat transfer occurs for the case of the hybrid nanoparticles, and then MgO-water, followed by the Ag-water. The nature of thermal flow parameters has been scrutinized.

Abstract Background Pre-existing comorbidities have been linked to SARS-CoV-2 infection but evidence is sparse on the importance and pattern of multimorbidity (2 or more conditions) and severity of infection indicated by hospitalisation or mortality. We aimed to use a multimorbidity index developed specifically for COVID-19 to investigate the association between multimorbidity and risk of severe SARS-CoV-2 infection. Methods We used data from the UK Biobank linked to laboratory confirmed test results for SARS-CoV-2 infection and mortality data from Public Health England between March 16 and July 26, 2020. By reviewing the current literature on COVID-19 we derived a multimorbidity index including: (1) angina; (2) asthma; (3) atrial fibrillation; (4) cancer; (5) chronic kidney disease; (6) chronic obstructive pulmonary disease; (7) diabetes mellitus; (8) heart failure; (9) hypertension; (10) myocardial infarction; (11) peripheral vascular disease; (12) stroke. Adjusted logistic regression models were used to assess the association between multimorbidity and risk of severe SARS-CoV-2 infection (hospitalisation/death). Potential effect modifiers of the association were assessed: age, sex, ethnicity, deprivation, smoking status, body mass index, air pollution, 25‐hydroxyvitamin D, cardiorespiratory fitness, high sensitivity C-reactive protein. Results Among 360,283 participants, the median age was 68 [range 48–85] years, most were White (94.5%), and 1706 had severe SARS-CoV-2 infection. The prevalence of multimorbidity was more than double in those with severe SARS-CoV-2 infection (25%) compared to those without (11%), and clusters of several multimorbidities were more common in those with severe SARS-CoV-2 infection. The most common clusters with severe SARS-CoV-2 infection were stroke with hypertension (79% of those with stroke had hypertension); diabetes and hypertension (72%); and chronic kidney disease and hypertension (68%). Multimorbidity was independently associated with a greater risk of severe SARS-CoV-2 infection (adjusted odds ratio 1.91 [95% confidence interval 1.70, 2.15] compared to no multimorbidity). The risk remained consistent across potential effect modifiers, except for greater risk among older age. The highest risk of severe infection was strongly evidenced in those with CKD and diabetes (4.93 [95% CI 3.36, 7.22]). Conclusion The multimorbidity index may help identify individuals at higher risk for severe COVID-19 outcomes and provide guidance for tailoring effective treatment.

The petrology of coal, as determined by the microscopic analysis of organic and inorganic elemental constituents of coal, provides information on its nature and characteristics. Coal is used worldwide in the production of thermal energy and coke. In the case of high-quality Colombian coals, only limited studies have been carried out. The present study presents the geochemical, mineralogical, and petrological characteristics of coal samples collected from Puerto Drummond in Cienaga, Colombia, to predict their potential uses. Therefore, the ultimate, proximate, petrographic, gross calorific value (GCV), ash fusion temperature, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), X-ray fluorescence (XRF), and Thermogravimetric (TG) analyses were employed in this study. The petrological analysis reveals that Colombian coals are naturally more abundant in vitrinite (72%) than inertinite (14–23%) macerals. Silicates and aluminosilicate are the main minerals present as fine particles mixed with macerals. The XRD and FTIR analyses show that the most common and dominant minerals are quartz, while gypsum, hematite, calcite and mica occur in lesser amounts. The oxide composition of the coal ashes consists of 51–58% SiO2 and 18–25% Al2O3 as determined by XRF analysis. In correlation and regression analysis, the moisture content shows a reverse correlation with GCV (Regression value of R2 = 0.68). This study helps researchers to comprehend the importance of Colombian coals and presents various techniques for characterisation of coals.

Abstract Background Although age, obesity and pre-existing chronic diseases are established risk factors for COVID-19 outcomes, their interactions have not been well researched. Methods We used data from the Clinical Characterisation Protocol UK (CCP-UK) for Severe Emerging Infection developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC). Patients admitted to hospital with COVID-19 from 6th February to 12th October 2020 were included where there was a coded outcome following hospital admission. Obesity was determined by an assessment from a clinician and chronic disease by medical records. Chronic diseases included: chronic cardiac disease, hypertension, chronic kidney disease, chronic pulmonary disease, diabetes and cancer. Mutually exclusive categories of obesity, with or without chronic disease, were created. Associations with in-hospital mortality were examined across sex and age categories. Results The analysis included 27,624 women with 6407 (23.2%) in-hospital deaths and 35,065 men with 10,001 (28.5%) in-hospital deaths. The prevalence of chronic disease in women and men was 66.3 and 68.5%, respectively, while that of obesity was 12.9 and 11.1%, respectively. Association of obesity and chronic disease status varied by age (p

Amoxicillin is the most widely used antibiotic in human medicine for treating bacterial infections. However, in the present research, Micromeria biflora’s flavonoids extract mediated gold nanoparticles (AuNPs) were conjugated with amoxicillin (Au-amoxi) to study their efficacy against the inflammation and pain caused by bacterial infections. The formation of AuNPs and Au-amoxi conjugates were confirmed by UV–visible surface plasmon peaks at 535 nm and 545 nm, respectively. The scanning electron microscopy (SEM), zeta potential (ZP), and X-ray diffraction (XRD) studies reveal that the size of AuNPs and Au-amoxi are found to be 42 nm and 45 nm, respectively. Fourier-transform infrared spectroscopy (FT-IR) absorption bands at 3200 cm−1, 1000 cm−1, 1500 cm−1, and 1650 cm−1 reveal the possible involvement of different moieties for the formation of AuNPs and Au-amoxi. The pH studies show that AuNPs and Au-amoxi conjugates are stable at lower pH. The carrageenan-induced paw edema test, writhing test, and hot plate test were used to conduct in vivo anti-inflammatory and antinociceptive studies, respectively. According to in vivo anti-inflammatory activity, Au-amoxi compounds have higher efficiency (70%) after 3 h at a dose of 10 mg/kg body weight as compared to standard diclofenac (60%) at 20 mg/kg, amoxicillin (30%) at 100 mg/kg, and flavonoids extract (35%) at 100 mg/kg. Similarly, for antinociceptive activities, writhing test results show that Au-amoxi conjugates produced the same number of writhes (15) but at a lower dose (10 mg/kg) compared to standard diclofenac (20 mg/kg). The hot plate test results demonstrate that the Au-amoxi has a better latency time of 25 s at 10 mg/kg dose when compared to standard Tramadol of 22 s at 30 mg/ kg, amoxicillin of 14 s at 100 mg/kg, and extract of 14 s at 100 mg/kg after placing the mice on the hot plate for 30, 60, and 90 min with a significance of (p ≤ 0.001). These findings show that the conjugation of AuNPs with amoxicillin to form Au-amoxi can boost its anti-inflammatory and antinociceptive potential caused by bacterial infections.

Abstract Background Cardiovascular disease accounts for about one-third of all premature deaths (ie, age =120 mmHg), diabetes, and BMI (>=22.5 kg/m2): 20 mmHg higher usual SBP about doubled cardiovascular mortality (RR 2.02, 95%CI 1.88–2.18]), as did diabetes (2.15, 1.95–2.37), and 10 kg/m2 higher usual BMI (1.92, 1.64–2.25). RR were similar in men and in women. The association with BMI and cardiovascular mortality was almost completely attenuated following adjustment for the mediating effect of SBP. Elevated SBP (>=120 mmHg), diabetes and raised BMI (>=22.5 kg/m2) accounted for 27%, 14%, and 16% of cardiovascular deaths, respectively. Conclusions This large prospective study provides direct evidence for the effects of these major risk factors on cardiovascular mortality in Cuba. Despite comparatively low levels of these risk factors by international standards, the strength of their association with cardiovascular death means they nevertheless exert a substantial impact on premature mortality in Cuba.

BackgroundMultiple long-term health conditions (multimorbidity) (MLTC-M) are increasingly prevalent and associated with high rates of morbidity, mortality, and health care expenditure. Strategies to address this have primarily focused on the biological aspects of disease, but MLTC-M also result from and are associated with additional psychosocial, economic, and environmental barriers. A shift toward more personalized, holistic, and integrated care could be effective. This could be made more efficient by identifying groups of populations based on their health and social needs. In turn, these will contribute to evidence-based solutions supporting delivery of interventions tailored to address the needs pertinent to each cluster. Evidence is needed on how to generate clusters based on health and social needs and quantify the impact of clusters on long-term health and costs. ObjectiveWe intend to develop and validate population clusters that consider determinants of health and social care needs for people with MLTC-M using data-driven machine learning (ML) methods compared to expert-driven approaches within primary care national databases, followed by evaluation of cluster trajectories and their association with health outcomes and costs. MethodsThe mixed methods program of work with parallel work streams include the following: (1) qualitative semistructured interview studies exploring patient, caregiver, and professional views on clinical and socioeconomic factors influencing experiences of living with or seeking care in MLTC-M; (2) modified Delphi with relevant stakeholders to generate variables on health and social (wider) determinants and to examine the feasibility of including these variables within existing primary care databases; and (3) cohort study with expert-driven segmentation, alongside data-driven algorithms. Outputs will be compared, clusters characterized, and trajectories over time examined to quantify associations with mortality, additional long-term conditions, worsening frailty, disease severity, and 10-year health and social care costs. ResultsThe study will commence in October 2021 and is expected to be completed by October 2023. ConclusionsBy studying MLTC-M clusters, we will assess how more personalized care can be developed, how accurate costs can be provided, and how to better understand the personal and medical profiles and environment of individuals within each cluster. Integrated care that considers “whole persons” and their environment is essential in addressing the complex, diverse, and individual needs of people living with MLTC-M. International Registered Report Identifier (IRRID)PRR1-10.2196/34405

This study investigates the parametric electrical and thermal performance of a novel photovoltaic trombe wall with a venetian blind system (PVTW-VB) in a semi-arid climatic conditions. A three-dimensional computational fluid dynamics (CFD) model is developed to determine the optimal parametric configuration for the PVTW-VB and is validated using experimental data. The experimental results indicated that the CFD model could accurately predict the operational performance of the PVTW-VB system. According to the findings, the VB spacing within the air gap, the VB angle, and the PVTW air flow rate should be 0.09 m, 60°, and 0.2 m/s, respectively. Additionally, PVTW-VB is compared with PVTW without VB. The average electrical power generation and PV panel surface temperature are found to be 8.6% higher and 3.2 °C lower in case of PVTW-VB configuration, respectively. Thermal regulation studies are conducted for three different test room configurations (i.e., a normal test room, test room with PVTW and test room with PVTW-VB). The study found that PVTW-VB system reduces the thermal load of the test room.

Nanofluids have been extensively studied in recent decades and have been regarded as “next-generation heat transfer fluids” due to their superior properties. However, dispersion stability and application at higher temperatures are among the challenges that must be overcome. In this work, a new class of stable hybrid nanofluid based on multi-walled carbon nanotube (MWCNT) + cupric oxide (CuO) nanocomposite is produced with Therminol55 (TH55) as the base fluid. Nanofluids' thermophysical characteristics are investigated at varying concentrations (0.005–0.08 wt%), and they are subsequently employed as the heat transfer medium in a tube heat exchanger (HEX) for the turbulent flow regime. Thermal conductivity was significantly increased by 128.4% at the maximum nanocomposite concentration of 0.08 wt%. Despite this, nanocomposites enhanced the nanofluids' viscosity, which climbed gradually with concentration to a maximum enhancement of around 25% at 0.08 wt%. The heat transfer performance of the formulated nanofluids was numerically assessed and found to be good; for example, when compared to pure TH55, the heat transfer coefficient improved by up to 128%. The highest increase in Nu was 38.4%, while the maximum increase in pumping power was determined to be 103.88%. Furthermore, the maximum exergy efficiency was 47.84% at a 0.08 wt% concentration and a Reynolds number (Re) of 12500, which is somewhat higher than the 40.96% attained with pure TH55. The highest thermal performance factor was 1.31 for 0.08 wt %, exceeding the maximum thermal performance factors of 1.17, 1.11, 1.08, and 1.03 for 0.04, 0.02, 0.01, and 0.005 wt %, respectively. Consequently, a nanofluid made of MWCNT + CuO/TH55 might be a promising candidate for usage as a heat transfer fluid.

Abstract Riemerella anatipestifer causes epizootic infectious disease in poultry resulting in serious economic losses especially to the duck industry. In our previous study, R. anatipestifer was found to lyse duck erythrocytes in vitro. In the present study, a random Tn4351 mutagenesis library of hemolytic R. anatipestifer strain SX containing 4000 mutants was constructed to investigate the genetic basis of hemolytic activity. Thirty mutants with reduced hemolytic activity and one with increased hemolytic activity were screened and insertions in 24 genes were identified. Of these genes, four were predicted to encode outer membrane proteins, one encoded a cytoplasmic membrane protein, 11 encoded cytoplasmic proteins, and eight encoded proteins with unknown locations. Based on current annotations of the R. anatipestifer genomes, of the 24 genes, 7 (29.17%) were involved in iron utilization. The hemolytic activities of the complemented strains M2 (pRES-Riean_0790) and M18 (pRES-Riean_0653) were restored, indicating that both Riean_0653 and Riean_0790 are involved in the hemolytic activity of strain SX. However, the recombinant proteins rRiean_0317, rRiean_0790, rRiean_0653, rRiean_1027, rRiean_1143, and rRiean_1561 had no hemolytic activity, suggesting that none were hemolysins.

The bactericidal effects of inhalable ciprofloxacin (CIP) loaded-poly(2-ethyl-2-oxazoline) (PEtOx) nanoparticles (NPs) with traces of zinc oxide (ZnO) were investigated against clinical strains of the respiratory pathogens Staphylococcus aureus and Pseudomonas aeruginosa. CIP-loaded PEtOx NPs retained their bactericidal activity within the formulations compared to free CIP drugs against these two pathogens, and bactericidal effects were enhanced with the inclusion of ZnO. PEtOx polymer and ZnO NPs did not show bactericidal activity alone or in combination against these pathogens. The formulations were tested to determine the cytotoxic and proinflammatory effects on airway epithelial cells derived from healthy donors (NHBE), donors with chronic obstructive pulmonary disease (COPD, DHBE), and a cell line derived from adults with cystic fibrosis (CFBE41o-) and macrophages from healthy adult controls (HCs), and those with either COPD or CF. NHBE cells demonstrated maximum cell viability (66%) against CIP-loaded PEtOx NPs with the half maximal inhibitory concentration (IC50) value of 50.7 mg/mL. CIP-loaded PEtOx NPs were more toxic to epithelial cells from donors with respiratory diseases than NHBEs, with respective IC50 values of 0.103 mg/mL for DHBEs and 0.514 mg/mL for CFBE41o- cells. However, high concentrations of CIP-loaded PEtOx NPs were toxic to macrophages, with respective IC50 values of 0.002 mg/mL for HC macrophages and 0.021 mg/mL for CF-like macrophages. PEtOx NPs, ZnO NPs, and ZnO-PEtOx NPs with no drug were not cytotoxic to any cells investigated. The in vitro digestibility of PEtOx and its NPs was investigated in simulated lung fluid (SLF) (pH 7.4). The analysed samples were characterized using Fourier transform infrared spectroscopy (ATR-FTIR), scanning electron microscopy (SEM), and UV–Vis spectroscopy. Digestion of PEtOx NPs commenced one week following incubation and was completely digested after four weeks; however, the original PEtOx was not digested after six weeks of incubation. The outcome of this study revealed that PEtOx polymer could be considered an efficient drug delivery carrier in respiratory linings, and CIP-loaded PEtOx NPs with traces of ZnO could be a promising addition to inhalable treatments against resistant bacteria with reduced toxicity.