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Mandarin, a prominent crop in Nepal, exhibits remarkable adaptability to different altitudes, resulting in diverse soil and nutrient conditions in orchards. Understanding these variations is crucial for optimizing orchard management practices and ensuring sustainable fruit production. This research endeavor sought to assess the nutritional profile of the soil in mandarin positioned at diverse elevations in Gorkha district, Nepal. The orchards were classified into five elevation groups: 800 masl, 900 masl, 1000 masl, 1100 masl, and 1200 masl. Using randomized complete block design (RCBD), each altitude contained ten composite soil samples, and was then subjected to chemical analysis to assess their properties. The results showed that soil pH increased with altitude, with the highest pH (6.66±0.045) and soil organic matter (OM) (5.88±0.12%) at 1200 masl and the lowest pH (5.5±0.045) and OM (1.92±0.12%) at 800 masl. Soil acidity was observed 5.79±0.045 at 900 masl and 5.5±0.045 at 800 masl, while all other altitudes had neutral soils. Nitrogen content followed a similar trend, with the highest at 1200 masl (0.32±0.007%) and the lowest at 800 masl (0.10±0.007%). Phosphorus and potassium showed no significant variation with altitude. Available phosphorus was the highest at 1000 masl (72.93±2.02 kg ha-1) and the lowest at 800 masl (51.61±2.02 kg ha-1). Maximum available potassium (365.34±6.84 kg ha-1) was observed at 1100 masl, while the minimum (337.63±6.84 kg ha-1) was recorded at 800 masl. In 18% of the samples, nitrogen exhibited the lowest concentration, while phosphorus was limiting in 12% of the samples. Potassium was not found to be a limiting nutrient in any of the samples. Variations in soil pH, OM, and nutrient content call for altitude-specific nutrient management to optimize mandarin production. Further studies are required in diverse ecology to characterize nutrient requirements and enhance sustainable mandarin cultivation practices. [Fundam Appl Agric 2023; 8(4.000): 698-705]

Abstract Creutzfeldt‐Jakob Disease is a rare neurodegenerative disease and earlier diagnosis is usually difficult. Combining clinical features with electroencephalogram, laboratory parameters, and neuroimaging findings will facilitate the diagnosis.

Abstract The majority of cases of Neurocysticercosis (NCC) are asymptomatic. Injudicious use of antihelmintics like albendazole (ALB) can cause cyst degeneration and perilesional inflammation, thus rendering asymptomatic individuals symptomatic with seizures, headache, vascular events, or cerebral edema. Mass drug administration (MDA) using ALB is a very common practice in developing countries like Nepal to contain transmission of soil-transmitted helminths (STH) and lymphatic filariasis (LF). Although the benefits of ALB-based MDA in the general population cannot be undermined, there can be severe consequences in certain groups, especially those with latent NCC. In this commentary, we discuss the effect it may have on such patients, and suggest potential solutions.

Background: Exposure to opioids after surgery is the initial contact for some people who develop chronic opioid use disorder. Hence, effective postoperative pain management, with less reliance on opioids, is critical. The Perioperative Opioid Quality Improvement (POQI) program developed (1) a digital health platform leveraging patient-survey-reported risk factors and (2) a postsurgical pain risk stratification algorithm to personalize perioperative care by integrating several commercially available digital health solutions into a combined platform. Development was reduced in scope by the COVID-19 pandemic., Objective: This pilot study aims to assess the screening performance of the risk algorithm, quantify the use of the POQI platform, and evaluate clinicians' and patients' perceptions of its utility and benefit., Methods: A POQI platform prototype was implemented in a quality improvement initiative at a Canadian tertiary care center and evaluated from January to September 2022. After surgical booking, a preliminary risk stratification algorithm was applied to health history questionnaire responses. The estimated risk guided the patient assignment to a care pathway based on low or high risk for persistent pain and opioid use. Demographic, procedural, and medication administration data were extracted retrospectively from the electronic medical record. Postoperative inpatient opioid use of >90 morphine milligram equivalents per day was the outcome used to assess algorithm performance. Data were summarized and compared between the low- and high-risk groups. POQI use was assessed by completed surveys on postoperative days 7, 14, 30, 60, 90, and 120. Semistructured patient and clinician interviews provided qualitative feedback on the platform., Results: Overall, 276 eligible patients were admitted for colorectal procedures. The risk algorithm stratified 203 (73.6%) as the low-risk group and 73 (26.4%) as the high-risk group. Among the 214 (77.5%) patients with available data, high-risk patients were younger than low-risk patients (age: median 53, IQR 40-65 years, vs median 59, IQR 49-69 years, median difference five years, 95% CI 1-9; P=.02) and were more often female patients (45/73, 62% vs 80/203, 39.4%; odds ratio 2.5, 95% CI 1.4-4.5; P=.002). The risk stratification was reasonably specific (true negative rate=144/200, 72%) but not sensitive (true positive rate=10/31, 32%). Only 39.7% (85/214) patients completed any postoperative quality of recovery questionnaires (only 14, 6.5% patients beyond 60 days after surgery), and 22.9% (49/214) completed a postdischarge medication survey. Interviewed participants welcomed the initiative but noted usability issues and poor platform education., Conclusions: An initial POQI platform prototype was deployed operationally; the risk algorithm had reasonable specificity but poor sensitivity. There was a significant loss to follow-up in postdischarge survey completion. Clinicians and patients appreciated the potential impact of preemptively addressing opioid exposure but expressed shortcomings in the platform's design and implementation. Iterative platform redesign with additional features and reevaluation are required before broader implementation., (©Matthias Görges, Jonath Sujan, Nicholas C West, Rama Syamala Sreepada, Michael D Wood, Beth A Payne, Swati Shetty, Jean P Gelinas, Ainsley M Sutherland. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 02.07.2024.)

Background: Anesthesiologists require an understanding of their patients' outcomes to evaluate their performance and improve their practice. Traditionally, anesthesiologists had limited information about their surgical outpatients' outcomes due to minimal contact post discharge. Leveraging digital health innovations for analyzing personal and population outcomes may improve perioperative care. BC Children's Hospital's postoperative follow-up registry for outpatient surgeries collects short-term outcomes such as pain, nausea, and vomiting. Yet, these data were previously not available to anesthesiologists., Objective: This quality improvement study aimed to visualize postoperative outcome data to allow anesthesiologists to reflect on their care and compare their performance with their peers., Methods: The postoperative follow-up registry contains nurse-reported postoperative outcomes, including opioid and antiemetic administration in the postanesthetic care unit (PACU), and family-reported outcomes, including pain, nausea, and vomiting, within 24 hours post discharge. Dashboards were iteratively co-designed with 5 anesthesiologists, and a department-wide usability survey gathered anesthesiologists' feedback on the dashboards, allowing further design improvements. A final dashboard version has been deployed, with data updated weekly., Results: The dashboard contains three sections: (1) 24-hour outcomes, (2) PACU outcomes, and (3) a practice profile containing individual anesthesiologist's case mix, grouped by age groups, sex, and surgical service. At the time of evaluation, the dashboard included 24-hour data from 7877 cases collected from September 2020 to February 2023 and PACU data from 8716 cases collected from April 2021 to February 2023. The co-design process and usability evaluation indicated that anesthesiologists preferred simpler designs for data summaries but also required the ability to explore details of specific outcomes and cases if needed. Anesthesiologists considered security and confidentiality to be key features of the design and most deemed the dashboard information useful and potentially beneficial for their practice., Conclusions: We designed and deployed a dynamic, personalized dashboard for anesthesiologists to review their outpatients' short-term postoperative outcomes. This dashboard facilitates personal reflection on individual practice in the context of peer and departmental performance and, hence, the opportunity to evaluate iterative practice changes. Further work is required to establish their effect on improving individual and department performance and patient outcomes., (©Rama Syamala Sreepada, Ai Ching Chang, Nicholas C West, Jonath Sujan, Brendan Lai, Andrew K Poznikoff, Rebecca Munk, Norbert R Froese, James C Chen, Matthias Görges. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 19.09.2023.)

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a significant worldwide health concern in recent months. The world has not dealt with such adversities since World War II. The spread has had a devastating and massive impact on global health, the economy, and people's everyday lives. With the crisis looming around the world, there is not yet any report of a clinically approved drug effective against this virus or or vaccine that can prevent people from getting infected. In this article, we describe different types of diagnostic tests currently used to detect SARS-CoV-2 infection. We also present an overview of the basic principles involved, advantages, and the pitfalls associated with each technique. This article also provides an insight into various supplementary diagnostic modalities, including recent advancements in sensing technologies and further clinical improvement and novelties to fight this pandemic.

In this study a one step method for the preparation of substituted anilides of quinoline-2-carboxylic acid was developed. This efficient innovative approach is based on the direct reaction of an acid or ester with substituted anilines using microwave irradiation. The optimized method was used for the synthesis of a series of eighteen substituted quinoline-2-carboxanilides. The molecular structure of N-(4-bromophenyl)quinoline-2-carboxamide as a model compound was determined by single-crystal X-ray diffraction. It crystallizes in the monoclinic space group with four molecules within the unit cell and the total structure of the compound can be described as "a slightly screwed boat".

In this study, a series of thirty-five substituted quinoline-2-carboxamides and thirty-three substituted naphthalene-2-carboxamides were prepared and characterized. They were tested for their activity related to the inhibition of photosynthetic electron transport (PET) in spinach (Spinacia oleracea L.) chloroplasts. Primary in vitro screening of the synthesized compounds was also performed against four mycobacterial species. N-Cycloheptylquinoline-2-carboxamide, N-cyclohexylquinoline-2-carboxamide and N-(2-phenylethyl)quinoline-2-carboxamide showed higher activity against M. tuberculosis than the standards isoniazid or pyrazinamide and 2-(pyrrolidin-1-ylcarbonyl)quinoline and 1-(2-naphthoyl)pyrrolidine expressed higher activity against M. kansasii and M. avium paratuberculosis than the standards isoniazid or pyrazinamide. The most effective antimycobacterial compounds demonstrated insignificant toxicity against the human monocytic leukemia THP-1 cell line. The PET-inhibiting activity expressed by IC(50) value of the most active compound N-benzyl-2-naphthamide was 7.5 μmol/L. For all compounds, the structure-activity relationships are discussed.