Environmental remediation of hazardous pollutants using MXene-perovskite-based photocatalysts: A review

Photocatalysis utilizing semiconductors offer a cost-effective and promising solution for the removal of pollutants. MXene and perovskites, which possess desirable properties such as a suitable bandgap, stability, and affordability, have emerged as a highly promising material for photocatalytic activity. However, the efficiency of MXene and perovskites is limited by their fast recombination rates and inadequate light harvesting abilities. Nonetheless, several additional modifications have been shown to enhance their performance, thereby warranting further exploration. This study delves into the fundamental principles of reactive species for MXene-perovskites. Various methods of modification of MXene-perovskite-based photocatalysts, including Schottky junction, Z-scheme and S-scheme are analyzed with regard to their operation, differences, identification techniques and reusability. The assemblance of heterojunctions is demonstrated to enhance photocatalytic activity while also suppressing charge carrier recombination. Furthermore, the separation of photocatalysts through magnetic-based methods is also investigated. Consequently, MXene-perovskite-based photocatalysts are seen as an exciting emerging technology that necessitates further research and development.

Phase I Study of Bortezomib, Fludarabine, and Melphalan, with or without Total Marrow Irradiation as Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with High-Risk or Relapsed/Refractory Multiple Myeloma

PURPOSE/OBJECTIVE(S)

Though outcomes of patients with multiple myeloma (MM) have improved, cure remains elusive. Allogeneic hematopoietic stem cell transplantation (allo-sCT) is associated with a lower relapse rate, but its role is hindered due to toxicities. We hypothesized that targeted total body irradiation in the form of total marrow irradiation (TMI) could safely facilitate allo-SCT via an improved toxicity profile. Therefore, we conducted a phase I study to investigate the safety and feasibility of a bortezomib (BTZ), fludarabine (FLU), and melphalan (MEL), with or without TMI, prior to allo-SCT for patients with high-risk (HR) or relapsed/refractory (R/R) MM.

MATERIALS/METHODS

Between 2012 and 2018 this study enrolled patients with HR or R/R MM on one of two strata, each comprising BTZ dose-escalation cohorts. Patients aged 18-60 with no prior radiation (RT) received TMI at 900 cGy (in 6 fractions delivered twice-daily), FLU, and MEL conditioning, with BTZ added in the second cohort (stratum I). Patients aged 18-70 with prior RT received FLU, MEL, and BTZ, without TMI (stratum II). The primary endpoint was feasibility of escalating doses of BTZ, with or without TMI, defined using a 3+3 design. Dose-limiting toxicity (DLT) was defined as any Grade 3+ Bearman toxicity or prolonged CTCAE v4.0 Grade 4+ neutropenia. Secondary endpoints included treatment response, time to neutrophil and platelet engraftment, incidence of acute (a) and chronic (c) graft-versus-host disease (GVHD), progression-free-survival (PFS), and overall survival (OS).

RESULTS

Eight patients were enrolled on stratum I. One of three patients in the first cohort of stratum I experienced DLT, which led to expansion to three more patients with no DLT. Cohort 2 enrolled only 2 patients due to low accrual, with BTZ added at 0.5 mg/m2; neither experienced DLT. Nine patients were enrolled on stratum II. Three patients were enrolled on cohort 1 (BTZ 0.5 mg/m2) and none experienced DLT. Three were enrolled on cohort 2 (bortezomib 0.7 mg/m2), and one experienced DLT. Therefore, the cohort expanded to three more patients. One more patient experienced DLT and 0.5 mg/m2 was considered the maximum tolerated dose. There were no primary or secondary graft failures. Complete response was achieved in 7 and 4 patients in strata I and II, respectively. Median follow-up for all patients was 30.7 months (mos) and was 99.8 mos for surviving patients. Median overall survival (OS) on strata I and II were 44.5 mos and 21.6 mos, respectively. Median PFS on strata I and II were 18.1 mos and 8.9 mos, respectively. In strata I, 5 patients developed Grade 2+ aGVHD and 8 developed extensive cGVHD. In strata II, 4 patients developed Grade 2+ aGVHD and 6 developed extensive cGVHD.

CONCLUSION

The TMI 900 cGy, FLU, and MEL conditioning regimen is considered safe as conditioning for allo-SCT and may warrant further investigation due to favorable response rates and survival; the conditioning regimen of FLU, MEL, and BTZ (0.7 mg/m2) is associated with unacceptable toxicities.

Changes in Salinity, Mangrove Community Ecology, and Organic Blue Carbon Stock in Response to Cyclones at Indian Sundarbans

Climate change-induced frequent cyclones are pumping saline seawater into the Sundarbans. Fani, Amphan, Bulbul, and Yaas were the major cyclones that hit the region during 2019-2021. This study represents the changes in the soil parameters, mangrove biodiversity and zonation due to the cyclone surges in the Indian Sundarbans between 2017 and 2021. Increasing tidal water salinity (parts per thousand) trends in both pre-monsoon (21 to 33) and post-monsoon (14 to 19) seasons have been observed between 2017 and 2021. A 46% reduction in the soil organic blue carbon pool is observed due to a 31% increase in soil salinity. Soil organic blue carbon has been calculated by both wet digestion and the elemental analyzer method, which are linearly correlated with each other. A reduction in the available nitrogen (30%) and available phosphorous (33%) in the mangrove soil has also been observed. Salinity-sensitive mangroves, such as Xylocarpus granatum, Xylocarpus moluccensis, Rhizophora mucronata, Bruguiera gymnorrhiza, and Bruguiera cylindrica, have seen local extinction in the sampled population. An increasing trend in relative density of salinity resilient, Avicennia marina, Suaeda maritima, Aegiceras corniculatum and a decreasing trend of true mangrove (Ceriops decandra) has been observed, in response to salinity rise in surface water as well as soil. As is evident from Hierarchical Cluster Analysis (HCA) and the Abundance/Frequency ratio (A/F), the mangrove zonation observed in response to tidal gradient has also changed, becoming more homogeneous with a dominance of A. marina. These findings indicate that cyclone, climate change-induced sea level rise can adversely impact Sustainable Development Goal 13 (climate action), by decreasing organic soil blue carbon sink and Sustainable Development Goal 14 (life below water), by local extinction of salinity sensitive mangroves.

Distribution, speciation, and bioaccumulation of potentially toxic elements in the grey mangroves at Indian Sundarbans, in relation to vessel movements

Sundarban is the world's largest mangrove wetland and home of 4.6 million people (Indian part), whose principal mode of communication is motorized boats (ferries). This study shed light on the role played by ferry movement in the speciation (following the BCR three-step sequential extraction method), ecological impact and bioaccumulation of potentially toxic elements (PTEs) in plant tissues (root and lamina) of grey mangrove (Avicennia marina) found near the five ferry ghats (ports). One-way ANOVA showed variation in major soil parameters (silt, clay, organic carbon, pH, Electrical conductivity) and PTEs (As, Cd, Cr, Cu, Hg, and Pb) between sites. Sequential extraction revealed that Cd was present in the 'exchangeable' form across the sites, Pb was in the 'reducible' form, and the rest of the PTEs were majorly found in 'residual' phase. Pollution indices revealed moderate to heavy contamination and considerable potential ecological risk due to Cd. Pearson correlation statistics and concentration variations indicate a relation between Pb and ferry movement frequency in the sites. Higher bioconcentration of Pb in the roots of A. marina, indicates phytostabilization action. Translocation factor for Cd in the leaves, indicates phytoextraction by A. marina. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) showed a close association between vehicle movement and Hg, Pb, Silt fraction, electrical conductivity, Cr, and As. This study recommends regular pollution monitoring across Sundarbans, as the PTEs in sediment-plant matrix can impact the higher trophic levels, human health through possible biomagnification in the detritus food chain, and can adversely impact the existing conservation initiatives.

Hydropower: A low-hanging sour-sweet energy option for India

India is the world's second largest populous nation, fifth largest economy with seventh largest geographical area but experiences high energy poverty. With the lowest per capita energy consumption among world's top ten economies, India ranks at 137 out of 218 nations. Hydropower has the potential to alleviate India's energy asymmetry as well as realize its sustainable growth aspiration of a low-carbon regime. However, hydropower in India has been plagued by debates on human displacement, loss of biodiversity, increased risk of natural disasters, and socio-economic conflicts making it an unpopular energy alternative. Here, we review and address various concerns related to India's hydropower sector, examine scientific evidence, analyze energy policy imperatives, geopolitical considerations, and future directions for a sustainable hydropower policy in India in the context of ongoing climate change. Evidence indicates that besides electricity generation, hydropower infrastructure helps: (i) avert floods, (ii) mitigate the impacts of global warming, and (iii) ensure redistribution of water to arid regions and improve water security. As a part of sustainable hydropower policy, we propose that most of the ecological and social problems associated with hydropower development can be avoided to a great extent through careful planning, proper project design, responsible ownership, and public participation. As short-term measures, we propose: (i) entrepreneurs and planners follow credible and transparent pre-project investigations, (ii) mandatory implementation of environmental management plans, and (iii) better accountability and transparency of statutory bodies as well as hydropower developers. For long-term measures, we suggest: (i) create a 'National Institute of Energy & Environmental Sustainability' to oversee post-project hydropower developmental activities, (ii) streamline various bureaucratic and institutional procedures, and (ii) establish a trans-boundary water management system for seamless and coordinated implementation of hydropower development programs across upstream-downstream nations.

Oesophageal carcinosarcoma: a rare neoplasm of the oesophagus

Oesophageal carcinosarcoma (OCS) is a rare oesophageal cancer, expressing both carcinomatous and sarcomatous elements. Although believed to have a better prognosis, no standard guidelines exist for its diagnosis and management. We report a case of a 60-year male presenting with progressive dysphagia and weight loss. Endoscopy and contrast-enhanced computed tomography of the chest revealed a large polypoidal intraluminal growth at the mid-oesophagus. Endoscopic biopsy revealed a sarcoma of the oesophagus. The patient underwent McKeown minimally invasive oesophagectomy. Final histopathology was suggestive of OCS. Postoperatively, the patient received adjuvant chemoradiation. At 20-month follow-up, he was asymptomatic with no radiological evidence of recurrence.

Variations in Soil Blue Carbon Sequestration between Natural Mangrove Metapopulations and a Mixed Mangrove Plantation: A Case Study from the World's Largest Contiguous Mangrove Forest

Sundarban is the world's largest mangrove wetland. This study, conducted in 2016, to compare blue carbon sequestration with different natural metapopulations and a four-year-old Avicennia marina (30% area)-Rhizophora mucronata (70% area)-mixed mangrove plantation under anthropoganic stress. The aims of the study is to find out the variations in soil ecological function indicators (pH, electrical conductivity, bulk density, soil texture, available nitrogn, phosphorus and soil organic carbon) and key ecological service indicator (soil blue carbon pool) between sites. Simpson's Index of dominance, diversity and Shannon-Weiner Index revealed that all the sites are under ecological stress, with the Suaeda maritima-dominated mudflat having the least biodiversity. It is also revealed that pH and electrical conductivity were highest in Suaeda maritima and Phoenix padulosa-dominated metapopulations, whereas organic carbon was the highest under the mangrove plantation and Avicennia marina-dominated site. Available nitrogen was recorded highest in the community with the Sonneretia sp.-Avicennia marina association. The mixed mangrove plantation had the highest blue carbon pool. The species diversity was not found to be related with the distance from the nearby conserved mangrove forest, contrary to the island biogeography theory. This study concludes with a recommendation of mixed mangrove plantations to restore the degraded saline mudflats along the human settlements across the globe.

Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms

BACKGROUND

Autoimmunity has been reported in patients with severe coronavirus disease 2019 (COVID-19). We investigated whether anti-nuclear/extractable-nuclear antibodies (ANAs/ENAs) were present up to a year after infection, and if they were associated with the development of clinically relevant post-acute sequalae of COVID-19 (PASC) symptoms.

METHODS

A rapid-assessment line immunoassay was used to measure circulating levels of ANAs/ENAs in 106 convalescent COVID-19 patients with varying acute phase severities at 3, 6 and 12 months post-recovery. Patient-reported fatigue, cough and dyspnoea were recorded at each time point. Multivariable logistic regression model and receiver operating curves were used to test the association of autoantibodies with patient-reported outcomes and pro-inflammatory cytokines.

RESULTS

Compared to age- and sex-matched healthy controls (n=22) and those who had other respiratory infections (n=34), patients with COVID-19 had higher detectable ANAs at 3 months post-recovery (p<0.001). The mean number of ANA autoreactivities per individual decreased between 3 and 12 months (from 3.99 to 1.55) with persistent positive titres associated with fatigue, dyspnoea and cough severity. Antibodies to U1-snRNP and anti-SS-B/La were both positively associated with persistent symptoms of fatigue (p<0.028, area under the curve (AUC) 0.86) and dyspnoea (p<0.003, AUC=0.81). Pro-inflammatory cytokines such as tumour necrosis factor (TNF)-α and C-reactive protein predicted the elevated ANAs at 12 months. TNF-α, D-dimer and interleukin-1β had the strongest association with symptoms at 12 months. Regression analysis showed that TNF-α predicted fatigue (β=4.65, p=0.004) and general symptomaticity (β=2.40, p=0.03) at 12 months.

INTERPRETATION

Persistently positive ANAs at 12 months post-COVID are associated with persisting symptoms and inflammation (TNF-α) in a subset of COVID-19 survivors. This finding indicates the need for further investigation into the role of autoimmunity in PASC.

Does COVID-19 lockdowns have impacted on global dengue burden? A special focus to India

Background

The world has been battling several vector-borne diseases since time immemorial. Socio-economic marginality, precipitation variations and human behavioral attributes play a major role in the proliferation of these diseases. Lockdown and social distancing have affected social behavioral aspects of human life and somehow impact on the spread of vector borne diseases. This article sheds light into the relationship between COVID-19 lockdown and global dengue burden with special focus on India. It also focuses on the interconnection of the COVID-19 pandemic (waves 1 and 2) and the alteration of human behavioral patterns in dengue cases.

Methods

We performed a systematic search using various resources from different platforms and websites, such as Medline; Pubmed; PAHO; WHO; CDC; ECDC; Epidemiology Unit Ministry of Health (Sri Lanka Government); NASA; NVBDCP from 2015 until 2021. We have included many factors, such as different geographical conditions (tropical climate, semitropic and arid conditions); GDP rate (developed nations, developing nations, and underdeveloped nations). We also categorized our data in order to conform to COVID-19 duration from 2019 to 2021. Data was extracted for the complete duration of 10 years (2012 to 2021) from various countries with different geographical region (arid region, semitropic/semiarid region and tropical region).

Results

There was a noticeable reduction in dengue cases in underdeveloped (70–85%), developing (50–90%), and developed nations (75%) in the years 2019 and 2021. The dengue cases drastically reduced by 55–65% with the advent of COVID-19 s wave in the year 2021 across the globe.

Conclusions

At present, we can conclude that COVID-19 and dengue show an inverse relationship. These preliminary, data-based observations should guide clinical practice until more data are made public and basis for further medical research.

• COVID-19 has increased the burden on the health care system across the globe.

• COVID-19 has inverse relation with the occurrence of Dengue cases.

• Dengue situation is worse in countries with low GDP.

• Human behavior and social distancing have direct correlation with the number of Dengue cases.

• Cross-reactivity or overlap between Dengue and COVID-19, has proportional effect on each other.

P-018 ACUTE APPENDICITIS IN DE GARENGEOT'S HERNIA - A LITERATURE REVIEW

Aim

This study aims to undertake a systematic review of published data, focussing on the incidence of acute appendicitis within a de Garengeot hernia, the relationship between pre-operative diagnosis, surgical technique, incidence and surgical outcomes.

Methods

A PRISMA modelled literature search was carried out across PubMed, ProQuest, and BMW Case Report databases with the search terms ‘Femoral Hernia’, ‘Appendix’, ‘de Garengeot's’ in combinations, limited to English language, published between 1960 to 2019. Authors report another case study that was not included in the systematic review.

Results

Systematic review identified 84 published data reporting 112 such cases. 74(66%) presented with painful groin swellings. CT performed in 43(38%) accurately diagnosed de Garengeot's in 32(74%) patients. The most common surgical approach was low approach 35(31%) followed by the inguinal approach 23 (21%). 81 (72%) underwent herniorrhaphy with non-absorbable sutures and 20 had mesh repairs (18%). Ten (9%) patients were reported to have postoperative morbidity with wound infection being the most common complication and one recorded death.

Conclusion

Rarity of de Garengeot's hernia is shown by the limited availability of data that restricted our ability to conclude a single diagnostic pathway or a specific surgical technique for this condition. CT has shown, relatively accurate form of imaging tool, as well as Ultrasound scans in some. Sequestrated appendicectomy and hernia repair via laparoscopy is an option, however, there is lack of data to warrant its effectiveness as the surgical option of choice over an open groin approach in the presence of incarcerated groin swelling.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Influence of micellar size on the structure of surfactant-DNA complexes

We have studied the structure of complexes of the cationic surfactant dodecyltrimethylammonium bromide (DTAB) with DNA as a function of surfactant to DNA base molar ratio (R) and salt concentration. Small-angle x-ray scattering data show the formation of nematic gels at lower and higher salt concentrations, irrespective of the value of R. Two crystalline phases are observed over intermediate salt concentrations; a square (S) phase for R>3 and a hexagonal (H_{S}) phase for lower R. Electron density maps of these phases show intercalated structures, with DTAB micelles sandwiched between long DNA strands. The composition of these complexes, estimated using elemental analysis, indicates that the micelles are not very long, and they occupy only about half of the interstitial volume between the DNA strands. This phase behavior is strikingly different from that of complexes of DNA with longer chain surfactants cetyltrimethylammonium bromide (CTAB) and tetradecyltrimethylammonium bromide (TTAB), which show only a hexagonal (H) phase over similar ranges of R and salt concentration, the H_{S} structure observed in the present study being a sqrt[3]×sqrt[3] superlattice of the H structure. Madelung energies of the S and H structures, calculated from the electrostatic interaction between their cylindrical constituents, suggest that the former is preferred in DTAB-DNA complexes due to the smaller micellar radius of DTAB. The propensity of DTAB to form short micelles seems also to favor the H_{S} phase at lower R. These results illustrate the important role of micellar size in determining the structure of these two-dimensional macro-ion crystals.

The relationship between myocardial microstructure and strain in chronic infarcts, assessed using diffusion tensor imaging and feature tracking

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): British Heart Foundation

Background

Cardiac diffusion tensor imaging (cDTI) is a novel technique for the non-invasive assessment of myocardial microstructure.  It allows in-vivo characterisation of microstructural changes post myocardial infarction (MI). Previously published evidence shows significant loss of sheetlet orientation as derived by cDTI secondary eigenvector (E2A), and loss of subendocardial cardiomyocytes derived by reductions in the proportions of myocytes with right-handed orientation (RHM) on helix angle (HA) maps. The assessment of myocardial strain by feature tracking (FT) allows the measurement of radial strain (RS), thought to be driven by the dynamic reorientation of laminar sheetlets, and longitudinal strain (LS), which is thought to relate to subendocardial function. We sought to explore the relationship between the strain and cDTI parameters in patients at 3 months following ST-elevation MI (STEMI).

Methods

Twenty five STEMI patients (M:F = 18:7, mean age 58 ± 9) underwent 3T CMR scan (mean interval 106 ± 17 days) with the following protocol: second order motion compensated (M2), free-breathing spin echo DTI (3 slices, 18 diffusion directions at b-values 100s/mm2, 200s/mm2 and 500s/mm2, acquired resolution was 2.20*2.27*8mm3; cine gradient echo and Late Gadolinium Enhancement (LGE) imaging. HA maps were described by dividing values into left-handed HA (LHM, -90&lt; HA &lt; -30), circumferential HA (CM, -30° &lt; HA &lt; 30°), and right-handed HA (RHM, 30° &lt; HA &lt; 90°) and reported as relative proportions. Segmental analysis were undertaken to derive: HA proportions, E2A, longitudinal strain and LGE%. Segments positive for LGE were classed as infarct segments.

Results

cDTI acquisition was successful in all patients (acquisition time 13 ± 5mins). Mean ejection fraction was 47 ± 8% with mean LGE in the infarcted segment of 57 ± 27%. Mean radial strain was 21 (95% confidence interval, 15-26). The mean E2A was 44 (95% confidence interval 41-47). There was a significant correlation between segmental radial strain and segmental E2A in infarcted segments (p &lt; 0.001, figure 1). In addition, segmental longitudinal strain correlated with the proportion of RHM on HA maps (p &lt; 0.02, figure 2).

Conclusion

Through the combined use of cDTI and FT in patients with chronic infarcts, our results show that the loss of sheetlet orientation assessed using E2A, correlates with worsening radial strain. Segments with less subendocardial cardiomyocytes, evidenced by a lower proportion of myocytes with right-handed orientation on HA maps, correlated with worse longitudinal strain. While this could potentially elucidate the complex association between myocardial microstructure and regional function, further studies are needed to define the incremental clinical value of cDTI.

Current Overviews on COVID-19 Management Strategies

The coronavirus pandemic has hit the world lately and caused acute respiratory syndrome in humans. The causative agent of the disease was soon brought to focus by scientists as SARS-CoV-2 and later called a novel coronavirus by the general public. Due to the severity and rapid spread of the disease, WHO classifies the COVID-19 pandemic as the 6th public health emergency even after taking efforts like worldwide quarantine and restrictions. Since only symptomatic treatment is available, the best way to control the spread of the virus is by taking preventive measures. Various types of antigen/antibody detection kits and diagnostic methods are available for the diagnosis of COVID-19 patients. In recent years, various phytochemicals and repurposing drugs are showing a broad range of anti-viral activities with different modes of action have been identified. Repurposing drugs such as arbidol, hydroxychloroquine, chloroquine, lopinavir, favipiravir, remdesivir, hexamethylene amiloride, and dexamethasone, tocilizumab, interferon-β, neutralizing antibodies exhibit in vitro anti-coronaviral properties by inhibiting multiple processes in the virus life cycle. Various research groups are involved in drug trials and vaccine development. Plant-based anti-viral compounds such as baicalin, calanolides, curcumin, oxymatrine, matrine, and resveratrol exhibit different modes of action against a wide range of positive/negative sense-RNA/DNA virus, and future researches need to be conducted to ascertain their role, use in managing SARS-CoV-2. Thus, this article is an attempt to review the current understanding of COVID-19 acute respiratory disease and summarize its clinical features with their prospective control and various aspects of the therapeutic approach.

Fugitive dust emission control study for a developed smart dry fog system

Air pollution due to dust emission is continuously increasing day by day in mining and allied industrial areas. Mining operations contribute a substantial amount of dust emission at the crushing, screening, and bulk material handling in loading areas. The ambient suspended dust particles create a severe nuisance to workers and local dwellers. For effective controlling of positive dust emission, an innovative automated dry fog dust suppression system (DFDSS) has been developed using hybrid nozzles, sensors, actuators, controllers, screw compressors, air receivers, pumps, motors, and water arrangement with filtration facility. The DFDSS was installed in a crushing and screening plant of an iron ore mine in India. Performance study indicted fugitive dust emission concentration values ranged from 354 to 7040 μg m^-3, which was reduced to 91-300 μg m^-3 after installation of DFDSS. The reduced values were within the permissible limit of 1200 μg m^-3 at a distance of 25 ± 2 m in the predominant downwind direction. The installed DFDSS added a meager addition of moisture content of 0.032% in the handling iron ore material, which was below the acceptable limit of 0.1%. The DFDSS precisely regulated fugitive dust emission from various mining activities without affecting the minerals processing performance. Thus, the DFDSS can be implemented effectively in different mining and allied industries where there is a dust emission problem.

Bioaccumulation of potentially toxic elements in three mangrove species and human health risk due to their ethnobotanical uses

The aim of this study was to assess probabilistic human health risk due to ethnobotanical usage of Avicennia officinalis, Porteresia coarctata and Acanthus ilicifolius. The study was conducted at the tannery outfall near Sundarban (Ramsar wetland, India) mangrove ecosystem  affected by potentially toxic elements (Cd, Cr, Cu, Hg, Mn, Ni, Pb, and Zn). Total metal concentrations (mg kg-1) were considerably higher in the polluted rhizosphere namely, Cd (1.05-1.97), Cu (36.3-38.6), Cr (144-184), Hg (0.04-0.19), Mn (163-184), Ni (37.7-46.4), Pb (20-36.6), and Zn (97-104). Ecological risk index indicated low to moderate ecological risk in this site, whereas the ecological risk factor showed high potential ecological risk due to Cd pollution. BCR Sequential extraction of metals showed more exchangeable fraction of Cd (47-55%), Cr (9-13%), Hg (11-13%), and Pb (11-15%), at the polluted site. Mercury, though present in trace amount in sediment, showed the highest bioaccumulation in all the three plants. Among the toxic trio, Hg showed the highest bioaccumulation in A. officinalis, Cd in P. coarctata but Pb has the lowest bioaccumulation potential in all the three species. Occasional fruit consumption of A. officinalis and dermal application of leaf, bark of A. officinalis (antimicrobial), A. ilicifolius (anti-inflammatory, pain reliever when applied on wounds) indicated negligible human health risk. However, long-term consumption of P. coarctata (wild rice variety) seeds posed health risk (THQ>1) both in adults and children age groups. This study concludes that nature of ethnobotanical use and metal contamination levels of the mangrove rhizosphere can impact human health. The transfer process of potentially toxic elements from rhizosphere to plants to human body should be considered while planing pollution mitigation measures. Graphical Abstract.

Potential human health hazard due to bioavailable heavy metal exposure via consumption of plants with ethnobotanical usage at the largest chromite mine of India

Usage of native plant species for traditional medicine or nutritional supplement is a popular practice among various cultures. But consumption of plants growing on polluted soil can cause serious human health hazard due to bioaccumulation of toxic heavy metals. Present study deals with the ecological and human health impact of heavy metals, in six native plant species with ethnobotanical significance growing at the largest chromite mine of India. Exchangeable, oxidizable, reducible and residual fractions of the metals in plant rhizosphere were analyzed. Only 2-6% of total Cr (270-330 mg/kg) and Ni (150-190 mg/kg) at the mining site is bioavailable. Cd showed highest bioavailability (~ 60%) in mining site posing very high ecological risk (1055-5291) followed by Ni (1297-2124) and Cr (309-1105). The heavy metals in the shoot of the targeted plants were about 0.7 to 80 times higher than the standard limit as per Indian statutory body. The total hazard quotient (THQ) by the consumption of plants growing in mining region was very high (> 1) and varied from 2.6 to 5.9 in adult and 0.6-1.3 in children, while in non-mining region the THQ of same plants indicates low risk (< 1). This study indicates THQ (adult) in the order of, Euphorbia hirta (5.9) > Calotropis procera (4.9) > Argemone mexicana (3.6) > Vernonia cinerea (3.5) > Pteridium latiusculum (3.4) > Tridax procumbens (2.6) through consumption pathway growing in mine soil. This study concludes that consumption of plants growing in heavy metal polluted soil should be avoided due to their potential health hazard.

Attitudes and perceptions about breastfeeding among female and male informal workers in India and South Africa

BACKGROUND

Worldwide, over 740 million women make their living in the informal economy and therefore lack formal employment benefits, such as maternity leave, that can improve infant feeding practices. Returning to work is one of the biggest challenges women face to maintaining breastfeeding. This study aimed to explore attitudes and perceptions towards breastfeeding in the informal work environment among male and female informal workers.

METHODS

The study used a qualitative research design. Purposive and snowball sampling was employed. Focus group discussions (FGDs) were conducted among men and women working in different types of informal jobs, in India and South Africa. Data was analysed using a thematic approach and the framework method.

RESULTS

Between March and July 2017, 14 FGDs were conducted in South Africa and nine in India. Most women were knowledgeable about the benefits of breastfeeding and reported initiating breastfeeding. However, pressures of family responsibilities and household financial obligations frequently forced mothers to return to work soon after childbirth. Upon return to work many mothers changed their infant feeding practices, adding breastmilk substitutes like formula milk, buffalo milk, and non-nutritive fluids like Rooibos tea. Some mothers expressed breastmilk to feed the infant while working but many mothers raised concerns about expressed breastmilk becoming 'spoilt'. Breastfeeding in the workplace was challenging as the work environment was described as unsafe and unhygienic for breastfeeding. Mothers also described being unable to complete work tasks while caring for an infant. In contrast, the flexibility of informal work allowed some mothers to successfully balance competing priorities of childcare and work. Sociocultural challenges influenced breastfeeding practices. For example, men in both countries expressed mixed views about breastfeeding. Breastfeeding was perceived as beneficial for both mother and child, however it was culturally unacceptable for women to breastfeed in public. This affected working mothers' ability to breastfeed outside the home and contributed to a lack of respect for women who chose to breastfeed in the workplace.

CONCLUSION

Mothers working in the informal sector face multiple challenges to maintaining breastfeeding. Interventions are required to support feeding and childcare if global nutrition and development goals are to be met.

Quantum Signature of a Squeezed Mechanical Oscillator

Recent optomechanical experiments have observed nonclassical properties in macroscopic mechanical oscillators. A key indicator of such properties is the asymmetry in the strength of the motional sidebands produced in the probe electromagnetic field, which is originated by the noncommutativity between the oscillator ladder operators. Here we extend the analysis to a squeezed state of an oscillator embedded in an optical cavity, produced by the parametric effect originated by a suitable combination of optical fields. The motional sidebands assume a peculiar shape, related to the modified system dynamics, with asymmetric features revealing and quantifying the quantum component of the squeezed oscillator motion.

Prostate-specific Antigen Bounce After Stereotactic Body Radiotherapy for Prostate Cancer: A Pooled Analysis of Four Prospective Trials

AIMS

We conducted a pooled analysis of four prospective stereotactic body radiotherapy (SBRT) trials of low- and intermediate-risk prostate cancer to evaluate the incidence of prostate-specific antigen (PSA) bounce and its correlation with the time-dose-fraction schedule. The correlation between bounce with PSA response at 4 years (nadir PSA < 0.4 ng/ml) and biochemical failure-free survival (BFFS) was also explored.

MATERIALS AND METHODS

The study included four treatment groups: 35 Gy/five fractions once per week (QW) (TG-1; n = 84); 40 Gy/five fractions QW (TG-2; n = 100); 40 Gy/five fractions every other day (TG-3; n = 73); and 26 Gy/two fractions QW (TG-4; n = 30). PSA bounce was defined as a rise in PSA by 0.2 ng/ml (nadir + 0.2) or 2 ng/ml (nadir + 2.0) above nadir followed by a decrease back to nadir. Patients with fewer than three follow-up PSA tests were excluded from the pooled analysis.

RESULTS

In total, 287 patients were included, with a median follow-up of 5.0 years. The pooled 5-year cumulative incidence of bounce by nadir + 2.0 was 8%. The 2-year cumulative incidences of PSA bounce by nadir + 0.2 were 28.9, 21, 19.6 and 16.7% (P = 0.12) and by nadir + 2.0 were 7.2, 8, 2.7 and 6.7% (P = 0.32) for TG-1 to TG-4, respectively. Multivariable analysis revealed that for nadir + 2.0, pre-treatment PSA (odds ratio 0.49; 95% confidence interval 0.26-0.97) correlated with PSA bounce. Although PSA bounce by nadir + 0.2 (odds ratio 0.10; 95% confidence interval 0.04-0.24) and nadir + 2.0 (odds ratio 0.29; 95% confidence interval 0.09-0.93) was associated with a lower probability of PSA response at 4 years, there was no association between bounce by nadir + 0.2 (hazard ratio 0.36; 95% confidence interval 0.08-1.74) or nadir + 2 (hazard ratio 1.77; 95% confidence interval 0.28-11.07) with BFFS.

CONCLUSION

The incidence of PSA bounce was independent of time-dose-fraction schedule for prostate SBRT. One in 13 patients experienced a bounce high enough to be misinterpreted as biochemical failure, and clinicians should avoid early salvage interventions in these patients. There was no association between PSA bounce and BFFS.

Distribution of heavy metals and associated human health risk in mine, agricultural and roadside soils at the largest chromite mine of India

This study accessed the levels of Cd, Cr, Fe, Mn, Ni, Pb and Zn concentration in soils of different locations (mine, roadside, agricultural and control sites) of Sukinda chromite mine (the India's largest Chromite mine and listed among the world's ten most polluted regions). Geo-accumulation (I_geo) index indicates that the mine, agricultural and roadside soils are 'heavily to extremely contaminated' due to Cr, Ni, Pb and Cd, hence human residing/working in this region can have health hazards due to contaminated soil via different exposure pathways. The concentration of heavy metals (mg/kg) in mine site vary between 52.35 and 244.8 (Cr⁶⁺), 12,030.2 and 31,818.6 (Cr³⁺), 5460.4 and 8866.0 (Ni), 70.02 and 208.6 (Pb), 0.95 and 5.3 (Cd), 209.1 and 360.4 (Mn), 21,531.8 and 28,847 (Fe) and 221 and 349.3 (Zn). Fe, Cr⁶⁺, Cr³⁺ and Ni concentration in soil follows an order of mine site > road sites > agricultural lands > control forest sites. Principal component analysis and hierarchical cluster analysis indicate Cd, Cr, Fe, Ni and Pb as major pollutants in the region. Cancer Risk is 'high' in both adult (5.38E-04) and children (4.45E-04) in mining sites and 'low' to 'very low' in agricultural and road side soils. The hazard index for all the heavy metals in a mining areas is varied from 2.9 to 5.2 in adult and 2.8-5.1 in children, indicating 'high' to 'very high' non-cancer risk due to significant contribution of Ni, Pb and Cr⁶⁺ concentration (73, 11 and 10%, respectively).

Highly acidic pH values of carbonated sweet drinks, fruit juices, mineral waters and unregulated fluoride levels in oral care products and drinks in India: a public health concern

PURPOSE

The objective of this study was to quantify and assess the concentrations of fluoride in commonly used oral care products, fruit juices, bottled waters, soft drinks, favoured bottled milk and milkshakes and to determine the pH of carbonated sweet drinks and drinks marketed in India.

MATERIALS AND METHODS

Various commercial brands of dentifrices, toothpowders, mouthwashes, bottled waters, sweet carbonated drinks and fruit juices were collected randomly from different outlets in Mangalore city, Karnataka, India. A fluoride ion-selective electrode was employed to estimate the fluoride concentrations. A standardised pH meter was used to detect pH in the drinks.

RESULTS

The fluoride level in toothpastes ranged between 96 and 1397 mg/l, whereas in toothpowder the fluoride content ranged from 35 to 1380 mg/l and mouthwash fluoride concentrations varied from 6 to 228 mg/l. The fluoride level in bottled waters ranged between 0.10 and 0.12 mg/l, and that in fruit juices between 0.09 and 0.21 mg/l. Most of the carbonated sweet drinks and fruit juices had highly acidic pH values which ranged between 2.62 and 4.26.

CONCLUSION

Of the wide variety of dentifrices and toothpowders available in India, most brands do not indicate the fluoride levels on their packaging or inserts. Similarly, the unregulated acidic pH values of carbonated sweet drinks are not only potentially contributing to non-carious tooth loss (enamel erosion and dentine erosion), but are also a contributing factor to the weight gain observed in Indian adolescents.

Imaging Correlations in Heterodyne Spectra for Quantum Displacement Sensing

The extraordinary sensitivity of the output field of an optical cavity to small quantum-scale displacements has led to breakthroughs such as the first detection of gravitational waves and of the motions of quantum ground-state cooled mechanical oscillators. While heterodyne detection of the output optical field of an optomechanical system exhibits asymmetries which provide a key signature that the mechanical oscillator has attained the quantum regime, important quantum correlations are lost. In turn, homodyning can detect quantum squeezing in an optical quadrature but loses the important sideband asymmetries. Here we introduce and experimentally demonstrate a new technique, subjecting the autocorrelators of the output current to filter functions, which restores the lost heterodyne correlations (whether classical or quantum), drastically augmenting the useful information accessible. The filtering even adjusts for moderate errors in the locking phase of the local oscillator. Hence we demonstrate the single-shot measurement of hundreds of different field quadratures allowing the rapid imaging of detailed features from a simple heterodyne trace. We also obtain a spectrum of hybrid homodyne-heterodyne character, with motional sidebands of combined amplitudes comparable to homodyne. Although investigated here in a thermal regime, the method's robustness and generality represents a promising new approach to sensing of quantum-scale displacements.

Straight-to-test colonoscopy for 2-week-wait referrals improves time to diagnosis of colorectal cancer and is feasible in a high-volume unit

AIM

We have introduced 'straight-to-test' (STT) colonoscopy as part of our 2-week-wait (2WW) pathway to address increasing numbers of urgent referrals for colorectal cancer (CRC) within the National Health Service. In this study we evaluated the ability of this initiative to shorten the time to diagnosis of CRC.

METHOD

We amended our 2WW referral form to include performance status and comorbidities. General practitioners were asked to provide data on estimated glomerular filtration rate and full blood count/ferritin. Our 2WW referrals were screened by a colorectal consultant and a nurse specialist. Those deemed unsuitable for STT were offered outpatient assessment (OPA).

RESULTS

Of 553 2WW referrals screened, 352 were considered suitable, 65 of whom failed a telephone assessment or were uncontactable, and accordingly 287 were offered the STT pathway. The STT group was significantly younger than the OPA group (median 65.9 years vs 78.7 years; P < 0.0001). STT colonoscopy significantly reduced the time to first test (13 days vs 22 days; P < 0.0001) and tissue diagnosis from the referral date (17 days vs 24.5 days; P < 0.0001). Thirty-seven (6.8%) CRCs were detected. Proportionately fewer patients in the STT pathway were managed with 'best supportive care only' compared with patients attending OPA (one of 15 vs six of 22, respectively). STT colonoscopy obviated the need for clinic attendance before testing in 287 patients, representing a potential net cost benefit of at least £48 500 in 4 months.

CONCLUSION

STT colonoscopy was safe and effective for selecting out a group of symptomatic patients who could proceed straight to endoscopic examination and receive a diagnosis more rapidly.

Sofosbuvir plus ribavirin in treatment-naïve patients with chronic hepatitis C virus genotype 1 or 3 infection in India

Until 2014, pegylated interferon plus ribavirin was the recommended standard of care for the treatment of chronic hepatitis C virus (HCV) infection in India. This open-label phase 3b study, conducted across 14 sites in India between 31 March 2014 and 30 November 2015, evaluated the efficacy and safety of sofosbuvir plus ribavirin therapy among treatment-naïve patients with chronic genotype 1 or 3 HCV infection. A total of 117 patients with genotype 1 or 3 HCV infection were randomized 1:1 to receive sofosbuvir 400 mg and weight-based ribavirin (1000 or 1200 mg) daily for 16 or 24 weeks. Among those with genotype 1 infection, the primary efficacy endpoint of sustained virologic response at 12 weeks post-treatment (SVR12) was reported in 90% (95% confidence intervals [CI], 73-98) and 96% (95% CI, 82-100) of patients following 16 and 24 weeks of treatment, respectively. For patients with genotype 3 infection, SVR12 rates were 100% (95% CI, 88-100) and 93% (95% CI, 78-99) after 16 and 24 weeks of therapy, respectively. Adverse events, most of which were mild or moderate in severity, occurred in 69% and 57% of patients receiving 16 and 24 weeks of treatment, respectively. The most common treatment-emergent adverse events were asthenia, headache and cough. Only one patient in the 24-week group discontinued treatment with sofosbuvir during this study. Overall, sofosbuvir plus ribavirin therapy achieved SVR12 rates ≥90% and was well tolerated among treatment-naïve patients with chronic genotype 1 or 3 HCV infection in India.

How to communicate climate change 'impact and solutions' to vulnerable population of Indian Sundarbans? From theory to practice

Introduction

Global consciousness on climate change problems and adaptation revolves around the disparity of information sharing and communication gap between theoretical scientific knowledge at academic end and practical implications of these at the vulnerable populations’ end. Coastal communities facing socio-economic stress, like densely populated Sundarbans, are the most affected part of the world, exposed to climate change problems and uncertainties. This article explores the successes of a socio-environmental project implemented at Indian Sundarbans targeted towards economic improvement and aims at communicating environmental conservation through organized community participation.

Case description

Participatory rural appraisal (PRA) and the wealth rank tool (WRT) were used to form a “group based organization” with 2100 vulnerable families to give them knowledge about capacity building, disaster management, resource conservation and sustainable agriculture practices. Training was conducted with the selected group members on resource conservation, institution building, alternative income generation activities (AIGA) like, Poultry, Small business, Tricycle van, Organic farming and disaster management in a participatory mode. The climate change ‘problems–solutions’ were communicated to this socio-economically marginalized and ostracized community through participatory educational theater (PET).

Discussion and evaluation

WRT revealed that 45 % of the population was under economic stress. Out of 2100 beneficiaries’, 1015 beneficiaries’ started organic farming, 133 beneficiaries’ adopted poultry instead of resource exploitive livelihood and 71 beneficiaries’ engaged themselves with small business, which was the success stories of this project. To mitigate disaster, 10-committees were formed and the endemic knowledge about climate change was recorded by participatory method validated through survey by structured questionnaire. As a part of this project 87 ha of naked deforested mudflat was reclaimed with endangered mangroves involving target community members aimed to sequester CO₂, control soil erosion and act as a barrier during natural disasters.

Conclusion

This case study concluded that participatory method of communication, aiming not only to communicate theoretical knowledge, but also to devise adaptation strategies through conservation of endemic knowledge, popularizing sustainability through Micro Finance Institutions and promoting AIGA along with motivating vulnerable community to restore degraded forest lands, could be a effective solution to practically combat climate change problems.

Electronic supplementary material

The online version of this article (doi:10.1186/s40064-016-2816-y) contains supplementary material, which is available to authorized users.

Rice Vision for Bangladesh: 2050 and Beyond

CORRECTION: Due to a number of formatting and layout issues, the PDF of this paper was replaced on 10th October 2016.Combined efforts of farmers, rice scientists, extension personnel and Government of Bangladesh have yielded clean rice growth rate of 0.34 million ton (MT) year-1 during 2009-10 to 2013-14 in the country. In 2014-15, the country acquired a rice surplus of about 2 MT. However, maintaining the current surplus of rice in the coming decades is a great challenge. Authentic estimation of future rice requirement and future resource availability would guide to way forward. This paper presents rice vision for Bangladesh leading to 2050 and beyond. In this study, secondary data from different government-owned statistics and research institutes were collected, analyzed and synthesized to develop models and/or model parameters to generate outputs such as future population, rice production and rice requirement. Population of Bangladesh will reach 215.4 million in 2050, when 44.6 MT of clean rice will be required. With the pace of rice-production-increase in the last five years, production can reach 47.2 MT, having a surplus of 2.6 MT in 2050. The study sets 2.6 MT as the target for clean rice surplus every year leading to 2050 and beyond. Several hurdles, such as increasing population, decreasing resources and increasing climate vulnerability, can hinder achieving the target. Three major interventions?accelerating genetic gain, minimizing yield gap and curtailing adoption lag?are proposed to break the barriers to achieve the target. Major challenges to implement the interventions include shrinking net cropped area, decreasing availability of irrigation water and increasing pressure on soil fertility. Smart technology such as, location specific variety, profitable cropping sequences, innovative cultural management, and mechanization coupled with smart dissemination using multiple means would ease production barriers. We recommend a number of measures, such as, guaranteeing a minimum cropped area, accelerating the rate of genetic gain in varietal development and intensifying collaboration among the stakeholders to reduce adoption lag of newly released promising rice varieties, to achieve the rice vision of Bangladesh leading to 2050 and beyond.Bangladesh Rice j. 2015, 19(2): 1-18