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Abstract Groundwater poisoning by heavy metals has caused serious health hazards in the exposed population globally. Manganese (Mn) poisoning causing human health hazards is very meagerly reported worldwide. The present research elucidates for the first time the catastrophic effect of manganese causing cancer in the Gangetic plains of Bihar (India). The blood samples of n = 1146 cancer patients were voluntarily obtained for the study, after their consent. Their household water samples were also collected for the study. All the samples were analysed for Mn contamination by Atomic Absorption Spectrophotometer. The study indicates high Mn contamination in the cancer patient blood samples with highest content as 6022 µg/L. Moreover, the cancer patient’s household handpump water samples also contained elevated Mn contamination. The correlation coefficient study finds significant association between Mn contamination in blood of cancer patients and their handpump water. The carcinoma group of cancer patients mostly in Stage III & IV had significant Mn contamination in their blood (above WHO/BIS permissible limit). The geospatial study depicts Mn contamination in handpump water in the state of Bihar in correlation with cancer patient’s blood samples. This novel finding is being reported in India for the first time, which correlates cancer with handpump drinking water. The long-term Mn exposure could be one of the causative agents for elevating cancer incidences. However, other confounding risk factors cannot be denied.

Abstract Background The prevalence of cognitive diseases, including Alzheimer’s disease and other forms of dementia, poses a significant global health challenge due to the limited availability of effective therapeutic options. Recent years have witnessed a growing emphasis in research on the exploration of natural compounds and their derivatives as prospective therapeutic agents for cognitive impairments. Main body Xanthotoxin, a furanocoumarin compound derived from botanical sources, exhibits promising therapeutic promise in several neurological conditions such as depression, neuronal inflammation, Alzheimer’s disease, vascular cognitive impairment, epilepsy, and Parkinson’s disease. This potential stems from its notable neuroprotective, antioxidant, and anti-inflammatory characteristics. The present study offers a comprehensive examination of the acquisition of XAT from both natural sources and synthetic means. It delves into the significance of XAT in the treatment of cognitive disorders and delineates potential avenues for future research in the domain of XAT and cognitive disorders. Conclusion Ongoing research and advancements in the field of XAT have the potential to enhance its use as a potent therapeutic intervention for cognitive impairments, consequently enhancing the holistic welfare of those afflicted by these incapacitating disorders.

Background: Wireless Holter monitors can be a great alternative to the traditional wired holter monitoring potentially giving better patient outcomes. However, the technology is new and less explored for the quality of ECG wave forms. Objective: This study was taken up to compare the quality of electrocardiogram (ECG) and arrhythmia detection using a traditional Holter and a wireless ambulatory smart ECG – Vigo SmartHeart (VSH) that functions with a Mobile application. Materials and Methods: The present study was cross-sectional in nature. We enrolled the patients indicated for continuous ECG monitoring. All the enrolled patients were connected to VSH wireless Holter solution and a conventional Holter monitor simultaneously. The ECGs generated were compared through descriptive statistics such as mean, standard deviation, and correlation by Pearson’s correlation method. Results: Seventy-one patients had simultaneous ECG recordings by both systems. The Pearson correlation for P wave, QRS, PR, QT, and ST was measured as 0.93, 0.93, 0.99, 0.36, and 0.98, respectively. The minimum heart rate (HR), maximum HR, RR interval, P wave, QRS complex, PR, and ST segments showed a statistically significant correlation between Smart Heart and Conventional Holter. 17 ECG events were reported, of which 14 were detected by both. The events missed by conventional Holter and detected by VSH were Atrioventricular block (2), Supraventricular tachycardia (1), and Intraventricular conduction delay (1). Conclusions: The quality of the report generated by both the methods was comparable to ECG wave quality, However, arrhythmia was picked up by the SmartHeart with better precision compared to conventional Holter. Thus, VSH can serve as a viable and potential alternative tool to screen and help in reducing the morbidity and mortality related to arrhythmias.

Introduction: Coeliac Disease (CD) is a systemic immune disorder caused by gluten in genetically susceptible individuals. A serological screening assay for CD has been designed to detect Immunoglobulin A (IgA) and IgG anti-tissue Transglutaminase (a-tTG) and IgA and IgG Deamidated Gliadin Peptide antibodies (a-DGP) simultaneously. The seronegative gap can be closed when these two antigens are combined on a single solid phase. This is primarily because untreated CD children who are negative for antibodies of one of the antigens may exhibit a positive result for the other. Aim: To determine the diagnostic parameters {sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV)} of tTG-IgA and htTG-DGP (Coeliac fusion- a combination of IgA and IgG to human tTG and synthetic DGP) for the diagnosis of CD in clinically symptomatic children. Materials and Methods: This cross-sectional study was conducted at the Paediatric Outpatient Department (OPD) of Santokhba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India from April 2023 to November 2023. The study population comprised 45 children (age >6 months and

Introduction: Children who are born with disability, more so intellectual disability are dependant on their parents for their daily needs. The presence of disabled child in the family adds to the caregiver burden which may read to emotional distress manifesting as anger, depression, stigma, etc. The study aimed to assess both the positive and negative impacts of having a disabled child in the family on caregivers. Methodology: The present, cross-sectional study was conducted in a rural area of Jammu district using simple random sampling, two health zones out of eight were selected for the conduct of the study. All the disabled children were identified and their parents were interviewed using National Institute of Mental Health-Disability Impact Scale Scale after taking an informed consent from them (IECGJ)(NO: IEC/GMC/2019/892). Results: During the course of the study, a total of 101 caregivers of disabled children were interviewed. Both negative and positive impact on the caregivers was found to be in close approximation to the tune of 15%–16%. Among the negative impacts, financial burden was the most dominant domain followed by physical care of the child and caregiver health being affected. Conclusion: It would be pertinent to conclude that we need to empower the caregivers as an important step for the inclusion of these special children in the society. In this context, few recommendations have been discussed in the present study.

The ongoing transition from a supply chain (SC) to net-zero emission (NZE) in SC performance must align with Sustainable Development Goal 13 to address climate change using life cycle assessment (LCA). Effective management of LCA significantly impacts an organization's competitiveness. With a lack of technology oversight and its connections with other enabling parameters that increase competitiveness, practices in the manufacturing industry remain limited. This study identifies and evaluates key enablers for LCA adoption in the manufacturing industry to achieve NZE in SC. Based on 123 responses, an exploratory factor analysis (EFA) was employed, followed by the Best-Worst Method (BWM). Further, a Fuzzy-Decision-Making Trial and Evaluation Laboratory (Fuzzy-DEMATEL) was used. The results revealed ‘organizational integration’, ‘data availability and quality, and ‘policy and regulation’ as significant group enablers that support NZSC to compete in the market. It provides insights for industry practitioners and policymakers on optimizing sustainable SC practices. The essential practical recommendations for resource optimization and carbon footprint reduction are also suggested.

In a Sustainable Supply Chain (SSC) context, information management offers a unique perspective on the digital economy and information management. Artificial intelligence (AI) is developing into a more robust digital field to facilitate quick information access and intelligent decisions in expanding commercial contexts. These days, Supply Chains (SC) would crumble without robust information systems. Applying AI and information management is crucial in determining the direction of sustainable supply chain management (SSCM). A systematic literature review (SLR) of the use of AI in SSCM is conducted in this research. The authors can identify crucial factors of the present literature using bibliometric and network analysis. AI is essential to the SSC to address sustainability challenges and manage the large volumes of data produced by numerous industrial processes. In the corpus of research that is already accessible, there is currently no comprehensive and bibliometric analysis of the potential for AI techniques for information management in SSC. Scientific publications were analysed from an objective point of view. Based on our results, we have drafted a proposal for an AI supply chain framework. Researchers, policymakers, and SCM practitioners may all benefit from the approach. This study is the first to analyse AI applications for information management in SSCM. In consideration of this, organizations are now exploring AI capabilities to improve operational efficiency and innovate their processes. This will assist industry people in understanding how AI methods support SC processes in their optimization to attain sustainability in SC practices.

Global market competitiveness and standards are pushing the manufacturing supply chain to adopt sustainable approaches to enhance quality, reduce waste, improve environmental practices, and optimize product costs. Blockchain technology has emerged as a promising tool for improving supply chain transparency and manufacturing sustainability. However, various challenges to the mainstream use of blockchain must be identified and addressed. In this regard, the study aims to identify and comprehend the challenges of adopting blockchain technology in the manufacturing sector to improve sustainable standards. To bridge this gap, the study used a three-step procedure. First, through a comprehensive literature review, 19 potential challenges were identified. Then, with the experts' discussion, a total of 18 challenges were finalized. In the second phase, data was collected from 15 professionals with industrial backgrounds. Lastly, the collected data was analyzed using Combined Compromise Solution methodologies and the Fuzzy-Decision-Making Trial and Evaluation Laboratory (fuzzy DEMATEL). This hybrid methodology prioritizes the challenges in blockchain adoption and categorizes them into causal groups. This improves the decision-making process by evaluating how the mutual impact of challenges in blockchain adoption affects achieving sustainability in the manufacturing supply chain. The outcomes of the presented work are validated through a sensitivity analysis of the outranked dimensions of blockchain adoption challenges. Results show that 'High Initial Investment Cost' and 'Lack of Digital Skills’ are the top challenges in its adoption. The findings of this work provide a roadmap to make the manufacturing supply chain sustainable and accomplish sustainability.

Silent estrus results in spread-out kidding and extended inter-kidding interval in goats. Progesterone (P4) priming for 12-14 days could be one of the approaches for estrus induction with optimum fertility. The present work was carried to comparatively assess the duration of P4 priming on estrus and fertility in silent estrus goats. Sirohi does (n=18) with a history of anestrus and high basal P4 in paired samples were equally divided into three groups. Does in P-0 d group received 200 IU of equine chorionic gonadotropin by intramuscular route. Does in group second and third were subjected to per-vaginal P4 sponges for 7 (P-7 d) and 14 (P-14 d) days, respectively and were given 200 IU equine chorionic gonadotropin following sponge withdrawal. Estrus was monitored for 72 h at 12 h intervals using teaser buck to record estrus per cent, induction time and duration. Estrus induction was highest in P-14 d (6/6) than P-0 d and P-7 d (4/6 and 5/6), respectively. Estrus induction time was shorter in P-7 d and P-14 d than P-0 d. The estrus duration was shortest in P-14 d group. The conception and pregnancy rate did not differ significantly among the groups, though all the does in P-14 d conceived. The fertility was non-significantly higher in P-14 d (6/6) and P-7 d group (5/5) than P-0 d (3/4). It could be concluded that P4 priming for 7-14 days in silent estrus does results in improved reproductive performances.

Egyptian clover/Berseem (Trifolium alexandrinum L.) is the most popular winter leguminous multi-cut fodder crop widely cultivated in the northwest and central parts of India. Quality seed significantly impacts farm productivity, farmers’ profitability, and socioeconomic welfare. Foundation and certified seeds enable high-quality seed production, making breeder seed (BS) the most important link in the seed supply chain. In India, berseem BS indent had increased from 1998 - 99 to 2012–13; afterwards, it followed a constant but decreasing trend. Of the 27 notified cultivars, 24 came into the seed supply chain between 1998–1999 and 2021–2022, indicating high varietal availability to stakeholders. The study examines the potential causes of the national decline in BS indent and production and the differences in these figures over time. The highest BS indent was received for the variety JB-1 (276.1 q), followed by BL-10 (205.1 q), Mescavi (165.6 q) and Wardan (153.7 q) from 1998 - 99 to 2021–22. The varietal replacement rate (VRR) is high, 43.30 %, for the varieties that have reached the age of five or less in the recent three years (2019–20 to 2021–22). Additionally, it has been calculated that if the seed chain operates at 100 % efficiency, the BS generated (48.1q) in 2021–22 can cover an area of almost 0.12 million hectares in 2024–25. The study offers an in-depth overview of berseem BS indent and production, an analysis of the difficulties encountered in BS production, and future directions for expanding variety and producing excess BS in the nation.

PURPOSEStandard-dose immune checkpoint inhibitors (SD-ICIs) are the standard of care as initial therapy in microsatellite instable-high (MSI-H) advanced/metastatic colorectal adenocarcinomas (mCRC), but there are preclinical data to suggest that low-dose ICIs (LD-ICI) might also have similar efficacy.MATERIALS AND METHODSA retrospective study of patients with MSI-H mCRC receiving ICIs between June 2017 and January 2023 was conducted. The primary end point of the study was 12-month progression-free survival (PFS), which was computed using the Kaplan-Meier method.RESULTSA total of 65 patients were available for analysis during the study period. Sixty patients (92%) received nivolumab, whereas the remaining received pembrolizumab. First-line ICIs were received by 18 patients (28%), whereas 47 patients (72%) received ICIs during later lines. Thirty patients (47%) received LD-ICIs (all received nivolumab), with the remaining receiving SD-ICIs (53%). At a median follow-up of 16.5 (95% CI, 11.8 to 21.2) months, median PFS was not reached in the entire cohort. The 12-month PFS rate in the LD-ICI cohort was 90%, whereas it was 75.8% in the SD-ICI cohort. There were no statistical differences in patients receiving ICIs as first-line therapy (12 months PFS—94.4%) or during later lines of therapy (12-month PFS—77.9%; P = .56).CONCLUSIONICIs in the current study show survivals which are similar to those seen in seminal trials in patients with MSI-H mCRC. Low-dose ICIs appear to work in MSI-H mCRC and should be explored prospectively in clinical trials. Patients with MSI-H status should be exposed to ICIs, whether initially or later during treatment, whenever feasible.

Summary: Lung cancer varies between Caucasians and Asians. There have been differences recorded in the epidemiology, genomics, standard therapies and outcomes, with variations according to the geography and ethnicity which affect the decision for optimal treatment of the patients. To better understand the profile of lung cancer in Southeast Asia, with a focus on India, we have comprehensively reviewed the available data, and discuss the challenges and the way forward. A substantial proportion of patients with lung cancer in Southeast Asia are neversmokers, and adenocarcinoma is the common histopathologic subtype, found in approximately a third of the patients. EGFR mutations are noted in 23–30% of patients, and ALK rearrangements are noted in 5–7%. Therapies are similar to global standards, although access to newer modalities and molecules is a challenge. Collaborative research, political will with various policy changes and patient advocacy are urgently needed.

Background: Postpartum depression refers to non-psychotic depressive episode that begins immediately after childbirth. Although delivering a baby is a happy event but many females develop depressive symptoms. About 13% of postpartum women experience a mental disorder, primarily depression worldwide. The aim is to estimate the prevalence of Postpartum depression among the mothers and to determine the association of Perceived Social Support, socio demographic and other obstetric variables with Postpartum depression. Methodology: The study was conducted among the Postpartum mothers attending the immunization section of a Tertiary care hospital, Jammu, India. Tools used are- Edinburgh Postnatal Depression Scale (EPDS), Hamilton depression Rating Scale (HDRS) and Multidimensional Scale of Perceived Social Support (MSPSS). SPSS software was used to analyse the data. Results: Prevalence of Postpartum Depression was found to be 16.1%. Variables like residence, occupation, h/o domestic violence, family h/o mental illness, eventful antenatal period, h/o hospitalization of baby, unwanted parenthood and low social support emerged to be independent predictors of Post Partum depression. Conclusions: Postpartum mothers particularly those, who were having poor social support are highly vulnerable to depression. Every postpartum mother should be screened for postpartum depression and timely referred to the psychiatrists. Also, family members need to be counselled.

The scarcity of high-quality forage has a significant influence on the productivity and profitability of livestock. Addressing this concern, an investigation was undertaken to assess the effects of distinct Italian ryegrass genotypes, namely, Punjab ryegrass-1, Kashmir collection, and Makhan grass, in conjunction with varying seeding ratios of Italian ryegrass to Egyptian clover. The seeding ratios considered were 100:0 (Italian ryegrass to Egyptian clover), 75:25, 50:50, and 25:75. All possible combinations of Italian ryegrass and Egyptian clover with seeding ratios were set up in a randomized complete block design and replicated thrice. Co-cultivating Italian ryegrass and Egyptian clover at a 75:25 seeding ratio yields the best yield benefit, as determined by the land equivalent ratio. It is noteworthy that in this configuration, real yield loss is higher for Egyptian clover and for Italian ryegrass when the seeding ratio is 25:75. The higher competitiveness of Italian ryegrass in comparison to Egyptian clover is highlighted by the competitive ratio. Notably, the nutritive parameter, crude protein yield, was significantly higher in the Makhan grass-based 50:50 and 75:25 seeding ratio. Results of the study ascertained the compatibility of grass-legume co-cultivation with significantly higher quantity and quality forage harvested under mixed cropping systems whereas Makhan grass as the superior and dominant genotype in comparison to Kashmir collection. The outcomes of this study revealed that the 100:0 seeding ratio, coupled with the Makhan grass genotype, exhibited superior performance in terms of cumulative forage harvest, dry matter accumulation, net returns, and benefit–cost ratio.

Agriculture is the second largest contributor (20 %) to total anthropogenic greenhouse gas (GHG) emissions in the world. There is a need to identify energy and carbon efficient cropping systems that reduce GHG emission and improve environmental quality. Using life cycle assessment (LCA), we evaluated the four cropping systems namely fallow – chickpea (F–C); Sesbania – mustard (Ses–M); blackgram – chickpea (B–C); sorghum + cowpea – mustard (S + C–M) cultivated during the 2018–2022 period. The energy use pattern and the input-output relationship were analysed. Three measures were utilized to quantify carbon footprints: CFa, which denotes emissions per unit area; CFb, indicating emissions per kilogram of yield; and CFe, representing emissions per unit of economic output. The result indicates that non-renewable sources of energy (diesel and fertilizer) contributed more than ∼80 % of the total energy consumed in the different cropping systems. The total energy requirement was the highest for S + C–M (16,972 MJ ha–1), followed by Ses–M (14,365 MJ ha–1), B–C (11,132 MJ ha–1) and F–C (8679 MJ ha–1) cropping systems. The S + C–M cropping system also had the highest energy use efficiency (9.13) followed by F–C (6.03), B–C (5.41) and Ses–M (5.41). The fallow–chickpea cropping system had the lowest values of CFa, CFb, and CFe however, the highest carbon efficiency (10.7) and the carbon sustainability index (9.7) were computed in S + C–M cropping system. Our findings indicate that thoughtfully structured, varied crop systems that integrate legumes and forage crops have the potential to significantly reduce energy consumption and carbon emissions, while sustaining or potentially improving overall productivity within these systems.

The crop water requirement of rice in different agroclimatic zones of Jharkhand, India was estimated using the CROPWAT 8.0 and CLIMWAT 2.0 models with data collected through NASA data-access-viewer on climate, soil, crop, and water availability. The evapotranspiration (ETo), effective rainfall (Peff), and crop water requirement (CWR) for the four zones of the Jharkhand State were calculated. Results revealed that the reference evapotranspiration (ETo) varied from 420.4 mm to 516.5 mm during the crop growing season of rice in different zones. The effective precipitation varied from 748.4 mm to 760.8 mm. The crop water requirement of rice varied from 482.5 mm to 592.4 mm. Effective rainfall was sufficient to meet the water requirement of rice in most of the zones except Alluvial zone wherein the net irrigation water requirement was only 67.6 mm.