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Livestock, the dairy sector in particular, has traditionally contributed to the Nepalese economy and livelihoods even though vegetarian centered food habits predominate. Despite a long chain of observations, discussions, and interventions, this sector has not realized substantial improvement. An International Livestock Research Institute (ILRI) developed tool, Feed Assessment Tool (FEAST), has been deployed to precisely analyze the livestock feeding system in the Kapilvastu, Palpa and Arghakhachi districts of Nepal. A large proportion of the populations, especially the youth segment, have migrated, and as a result the area under agricultural production is ever decreasing. The typical crop production pattern does not reflect any dominance of fodder crops, which limits the availability of feed and posesa serious threat to the expansion of commercial dairy enterprises. Additional barriers to increased productivity include a limited supply of labor, competition for resources (i.e. labor, land) with rice production and the significant number of indigenous dairy animals in the national herd. Policy barriers that include unaffordable credit, limited access to inputs and inadequate government support further hinder potential growth of the dairy sector of this region. A dairy focused program to utilize the land and other resources to commercialize the dairy sector in order to tap the potential of this geography could be the only alternative to contribute toward meeting the national objective of making the country self-sufficient in milk and its products by 2020. [ABSTRACT FROM AUTHOR]

Breakage of hardware is not an uncommon complication in spine surgery practice. Pedicle screw breakage is the commonest instrument failure encountered in spine surgery, and different relatively simple, techniques have been recommended to retrieve the threaded part of it. Peroperative breakage of an instrument like pedicle seeker and jaw of disc forceps is unpredictable and removal of an unthreaded smooth implant is difficult. We experienced breakage of the pedicle seeker while putting a pedicle screw in a case of spondylolisthesis and breakage of the mobile jaw of a disc forceps in another case of prolapsed intervertebral disc. Here we present an innovative technique of removal of the broken instrument through the pedicle. Regular maintenance and replacement of al old instrument is recommended. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. Many patients suffering from chronic obstructive lungs diseases are of poor economic status, mostly illiterate, therefore has a direct bearing on patient compliance. Tiotropium is a new anticholinergic therapy for chronic obstructive pulmonary disease that differs from ipratropium by its functional relative selectively for musarinic receptor subtypes and which allows single dosing a day. This study presents a cost-effectiveness, efficacy, and side-effects of Ipratropium bromide and Tiotropium in COPD. Methods: Prospective study was conducted In Kathmandu University Teaching Hospital, between the year 2008 and 2009 in terms of cost-effectiveness, efficacy, and side-effects of Tiotropium and Ipratropium amongst COPD patients. Results: Tiotropium and Ipratropium were prescribed in total of 57 patients (30 in ipratropium bromide and 27 in tiotropium bromide) for the management of COPD among outpatients. There were no significant differences in age, height, weight and baseline lung function parameters (FEV1 and PEF) between the two drugs i.e. ipratropium bromide and tiotropium bromide. Significant improvement in lung function parameters were found in each respective group of drugs after bronchodilator therapy. Tiotropium results in significant reduction of Chronic Obstructive Pulmonary disease exacerbations and significant improvement in quality of life, lung function, and dyspnoea compared to ipratropium. The additional cost to achieve these favorable outcomes was cheaper than Ipratropium bromide. (Nepalese Rs. 7.03 per day for tiotropium as compared to Rs. 9.06 for Ipratropium) Conclusions: Tiotropium results in significant reduction of chronic obstructive pulmonary disease exacerbations and significant improvement in quality of life, lung function and dyspnoea compared to Ipratropium. [ABSTRACT FROM AUTHOR]

Price uncertainty is faced by Gencos in the scheduling of their units in competitive power markets. The proper way to deal with the uncertainty depends on the risk preference of the Genco. Two important means to manage the price uncertainty are (i) suitable flexible bids and (ii) the use of hedging tools such as forward contracts. The influence of these factors in the Genco's short-term generation planning and the corresponding profit performances is studied. The market price is represented by lognormal distribution, Genco risk behaviour is represented by exponential utility functions, the bid functions are taken to be flexible and simple contracts for hedging are assumed available. The unit commitment problem is combined with the hedging problem to obtain the optimal solution. Formulation of the problem to maximise profit in the spot market and its extension to incorporate the risk behaviour of the Gencos and the forward contacts for hedging is presented. Solution method based on genetic algorithms is implemented in MATLAB. It is observed through numerical examples that the flexible outputs and the forward contracts can be used to hedge against price risks to achieve desired profit performance according to Gencos' risk behaviour. [ABSTRACT FROM AUTHOR]

Bidding plays an important role for Gencos participating in competitive electricity markets with the objective of maximising profit. While making bidding strategies, factors like characteristics of generators and price uncertainty need to be considered as they have direct impact on the expected profit. In this work, a method of building an optimal bid curve under price uncertainty using price-based unit commitment (PBUC) is presented. The results indicate a simple yet an effective bidding method. [ABSTRACT FROM AUTHOR]

A case study of 6 Year old female child with Taenia saginata, a food-borne disease, is presented, and mentions importance of early and correct identification of the Taenia species for treating the disease.

Introduction: Rotavirus is one of the most common causes of acute gastroenteritis among infants and young children. The spread of rotavirus infection in pediatric wards can cause acute diarrhoea during hospitalization, and in turn, prolong hospitalization or need, rehospitalization. The aim of the study was to determine the prevalence of nosocomial infection due to rotavirus and other causal organisms among children less than 5 years of age. Methodology: A cross-sectional study between November 2009 and May 2010 was conducted among 96 pediatric patients in children hospital, Nepal. Stool samples were collected during hospitalization and up to 3 days after discharge from the hospital. Rotavirus antigens were detected by EIA and standard microbiological procedure were applied for other enteric pathogens. Results: The prevalence of nosocomial infection due to rotavirus was 30.2% (29/96). Of them, 16 (55.17%) of the 29 children with nosocomial infection during hospitalization and/or up to 72 hours after discharge developed diarrhoea. The prevalence of symptomatic cases of nosocomial infection was 55.17% (16/29), which involved 16.7% (16/96) of the study subjects, showing a prevalence of 44.82% (13/29) for asymptomatic nosocomial infection consisted of 13.54% (13/96) of the total subjects. Eleven of the 16 symptomatic subjects of nosocomial infection were affected by diarrhoea during hospitalization and five subjects after discharge. Bacteria (8.3%) and protozoa (5.2%) agents were also causing nosocomial infection in children. Conclusions: Children attending hospital may asymptomatically carry enteric pathogens and potentially act as source of nosocomial infection. Due to the relatively high frequency of nosocomial infection in the Children Hospital of Nepal, it is necessary to follow strictly hygienic rules such as isolation of patients with diarrhoea and hand-washing before and after the examination of each patient and cleaning the examination instruments after use in each patient. [ABSTRACT FROM AUTHOR]

Decoherence-free subspaces and subsystems (DFS) preserve quantum information by encoding it into symmetry-protected states unaffected by decoherence. An inherent DFS of a given experimental system may not exist; however, through the use of dynamical decoupling (DD), one can induce symmetries that support DFSs. Here, we provide the first experimental demonstration of DD-generated decoherence-free subsystem logical qubits. Utilizing IBM Quantum superconducting processors, we investigate two and three-qubit DFS codes comprising up to six and seven noninteracting logical qubits, respectively. Through a combination of DD and error detection, we show that DFS logical qubits can achieve up to a 23% improvement in state preservation fidelity over physical qubits subject to DD alone. This constitutes a beyond-breakeven fidelity improvement for DFS-encoded qubits. Our results showcase the potential utility of DFS codes as a pathway toward enhanced computational accuracy via logical encoding on quantum processors., (Creative Commons Attribution license.)

Background: Critically ill patients experience intense physical and psychological stressors in the intensive care unit (ICU). More than half of ICU survivors report overwhelming mental health symptoms after ICU discharge, such as post-traumatic stress symptoms, anxiety, and depression. Relaxation-inducing integrative therapies such as guided imagery, massage, therapeutic touch, music therapy, and spirituality-based healing practices have the potential to promote comfort and relaxation and improve patient outcomes., Objectives: The aim of this study was to explore the attitudes of healthcare professionals towards the implementation of relaxation-inducing integrative therapies in critical care, barriers to implementation, and potential strategies to overcome them., Methods: We conducted seven focus group interviews with 23 critical care clinicians (70% nurses, 17% allied health professionals, 13% physicians). Interviews were audiotaped and transcribed verbatim. Data were thematically analysed using an inductive content analysis approach., Findings: Results reveal a constant interplay between mostly positive personal attitudes towards implementation of integrative therapies and the perceived culture and priorities of the unit. The main benefits for critically ill patients as perceived by participants were promotion of comfort, sleep, and coping, increase of trust, and decrease of pain and stress. As for barriers, dominant themes were a perceived lack of evidence, cost, and time constraints and the fear of loss of professional credibility. Participants related nurses' education and training, family involvement, and leadership were seen as main strategies for implementation., Conclusions: The dominant ICU culture needs to be considered when implementing integrative therapies. Education, access to evidence, and role modelling are proposed as means to shift the ICU culture towards utilisation of integrative therapies in critical care., (Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

An eleven year old male reported a ten-day history of unilateral pain, redness, and sudden loss of vision. Ophthalmic examination revealed panophthalmitis that did not respond to conventional intravenous antibiotics, and systemic deterioration raised suspicion of a fungal aetiology. However, the worsening of the ocular condition from panophthalmitis to orbital cellulitis upon commencement of amphotericin B suggests the presence of a fastidious microorganism. Aspergillus terreus was isolated from a vitreous tap sample and responded well to intravenous voriconazole, exhibiting a distinct antimicrobial susceptibility spectrum and emphasising its possible involvement in relatively healthy early adolescence. To the author's knowledge, panophthalmitis with orbital cellulitis in early adolescence, without prior ocular insult, paranasal sinus involvement, or immunocompromised status, has not been reported previously., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

β-Thalassemia is an inherited genetic disorder associated with β-globin chain synthesis, which ultimately becomes anemia. Adenosine-2,3-dialdehyde, by inhibiting arginine methyl transferase 5 (PRMT5), can induce fetal hemoglobin (HbF) levels. Hence, the materialization of PRMT5 inhibitors is considered a promising therapy in the management of β-thalassemia. This study conducted a virtual screening of certain compounds similar to 5'-deoxy-5'methyladenosine (3XV) using the PubChem database. The top 10 compounds were chosen based on the best docking scores, while their interactions with the PRMT5 active site were analyzed. Further, the top two compounds demonstrating the lowest binding energy were subjected to drug-likeness analysis and pharmacokinetic property predictions, followed by molecular dynamics simulation studies. Based on the molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) score and molecular interactions, (3R,4S)-2-(6-aminopurin-9-yl)-5-[(4-ethylcyclohexyl)sulfanylmethyl]oxolane-3,4-diol (TOP1) and 2-(6-Aminopurin-9-yl)-5-[(6-aminopurin-9-yl)methylsulfanylmethyl]oxolane-3,4-diol (TOP2) were identified as potential hit compounds, while TOP1 exhibited higher binding affinity and stabler binding capabilities than TOP2 during molecular dynamics simulation (MDS) analysis. Taken together, the outcomes of our study could aid researchers in identifying promising PRMT5 inhibitors. Moreover, further investigations through in vivo and in vitro experiments would unquestionably confirm that this compound could be employed as a therapeutic drug in the management of β-thalassemia.

There has been limited research and understanding of the water quality in developing countries. Fresh produce consumed raw is nutrient-dense but is more susceptible to causing foodborne illness when contaminated water is used in production and consumption. There have been increasing reported incidences of foodborne outbreaks in Nepal linked to fresh produce contamination. However, water used in washing fresh produce by consumers and water used by growers or vendors is rarely tested. This research examines the source water used by consumers and growers in fresh produce systems in Nepal. To examine Escherichia coli (E. coli) detection as an indicator of contamination risk in water, we selected five major metropolitan cities for consumer households and ten districts representing commercial growers of vegetable growing areas of all seven provinces of Nepal. Altogether, we collected 394 water samples from randomly selected individual households: 156 from consumer households and 238 from growers or vendors. Results suggest that 59% of the water used in fresh produce systems is contaminated with E. coli in Nepal. On the water source used by consumers to wash fresh produce before consumption, we found that the dominant sources are the stored water in tanks or containers (46%) and municipal or communal supply water (39%)-which have E. coli prevalence rate of 66% and 57%, respectively. On the dominant sources of water used in fresh produce by growers or vendors, we found up to 88% of E. coli prevalence in the water they use. We also discussed the location or regional differences in contamination risks. This nationally represented study has implications for intervention policies and programs for safer food production and consumption practices in countries like Nepal where food safety is an emerging priority., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Many environmental factors can disrupt sleep and circadian rhythms, yet the consequences of such disruptions are poorly understood. The main goals of this project were to study the effects of disrupted circadian rhythms and sleep disturbance on Drosophila melanogaster's : (1) lifespan, (2) depression-like behaviors, and (3) propensity to consume caffeine-containing media. Three experimental groups were used: controls, Circadian Dysfunction (CD), and Sleep Disturbance (SD). Circadian disruption (CD): used flies with Tim 01 mutation, which eliminates circadian behavioral rhythms. Sleep disturbance (SD): used flies subjected to hourly light exposure and manual mechanical disruption, for 48 hours. To assess the effect on lifespan, the percent of flies surviving over time, within each group, was calculated. Impaired geotaxis, or loss of climbing motivation, was assessed as a measure of a depression-like state. Preference for caffeine-containing food was evaluated using a choice chamber where caffeine enriched, and regular media were presented to flies. Group differences were analyzed with survival curves. Chi-square tests were used for the categorical variables. Survival curve analysis showed that Flies with the timeless gene mutation ( tim 01 ) have a significantly shorter lifespan than controls. Geotaxis was not significantly impaired by sleep disturbance, but it was negatively affected by circadian dysfunction. Both the Circadian Dysfunction and Sleep Disturbance groups showed a preference for caffeine-containing food, after 72 hours of exposure to it, although the Circadian Dysfunction group was much more affected than the Sleep Disturbance group. Sleep and circadian disturbances can negatively influence physical and mental wellbeing and the accompanying molecular mechanisms, as well as disrupted brain physiology, must be studied. It is critical to identify and minimize social and environmental disruptors of such biological rhythms., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Migrant and refugee women experiencing domestic violence (DV) may face compounding factors that impact their ability and experiences of seeking help. Health-care providers are in a unique position to identify and assist victims of DV, however, they often lack the confidence and training to do this well. Little is known of the health-care experiences of migrant and refugee women experiencing abuse when they access primary health care (PHC). Using scoping review methodology, we undertook a systematic search of seven databases (Medline, Scopus, ProQuest, CINAHL, Informit Complete, and Google Scholar). We sought peer-reviewed and grey literature, published in English between January 1980 and August 2021 that identified women (18+) who had experienced DV, from low- or middle-income countries (LMICs), seeking help or health care in a primary care setting of a high-income country (HIC). Nine articles met the inclusion criteria. Findings identify sociocultural and sociopolitical barriers for migrant and refugee women seeking help for DV, which are contextualized within the ecological model. Migration-related factors and fear were major barriers for migrant and refugee women, while kindness, empathy and trust in health-care providers, and children's well-being were the strongest motivators for help-seeking and disclosure. This review provides insight into an under-researched and marginalized group of victim-survivors and highlights the need for increased awareness, guidance, and continuing education for health-care providers and health-care systems to provide best practice DV care for migrant and refugee women., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.