The scientific payload of the Ultraviolet Transient Astronomy Satellite (ULTRASAT)

The Ultraviolet Transient Astronomy Satellite (ULTRASAT) is a space-borne near UV telescope with an unprecedented large field of view (200 sq. deg.). The mission, led by the Weizmann Institute of Science and the Israel Space Agency in collaboration with DESY (Helmholtz association, Germany) and NASA (USA), is fully funded and expected to be launched to a geostationary transfer orbit in Q2/3 of 2025. With a grasp 300 times larger than GALEX, the most sensitive UV satellite to date, ULTRASAT will revolutionize our understanding of the hot transient universe, as well as of flaring galactic sources. We describe the mission payload, the optical design and the choice of materials allowing us to achieve a point spread function of ~10arcsec across the FoV, and the detector assembly. We detail the mitigation techniques implemented to suppress out-of-band flux and reduce stray light, detector properties including measured quantum efficiency of scout (prototype) detectors, and expected performance (limiting magnitude) for various objects.Comment: Presented in the SPIE Astronomical Telescopes + Instrumentation 202

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Role of extracorporeal shockwave therapy in patients with rotator cuff tendinopathy: synthetic analysis of last two decades

Objective: The study is designed explore the current evidence on effectiveness of shockwave therapy in patients with rotator cuff tendinopathy from 2000-2019. Methodology: Data bases were searched including Cochrane, Medline, Embase and PEDro from 2000 to latest. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was performed using Cochrane risk of bias tool and included studies were critically appraised using PEDro scale. Results: In current review, 11 articles were finally included based on eligibility criteria. However data was not extractable from 2 studies due to which 9 studies were finally reviewed as shown in figure I. There were 8 Randomized trials and 1 randomized pilot study. The summary of critical appraisal of included studies through PEDro scale was done which showed that 4 studies had high quality and 5 studies fall under the category of fair. Conclusion: Extracorporeal shockwave therapy showed significant improvement in terms of reducing pain and improving functional mobility as compared to traditional rehabilitation in patients with rotator cuff tendinopathy in some studies however in others results were not found to be significant. This systematic review has established that there is no consensus between both interventions however; extracorporeal shockwave therapy is an acceptable practical alternative among patients having tendinopathy. Keywords: Extracorporeal shockwave therapy, Rotator cuff tendinopathy, Systematic review, Continuous..

New challenges in the use of nanomedicine in cancer therapy

Nanomedicines are applied as alternative treatments for anticancer agents. For the treatment of cancer, due to the small size in nanometers (nm), specific site targeting can be achieved with the use of nanomedicines, increasing their bioavailability and conferring fewer toxic side effects. Additionally, the use of minute amounts of drugs can lead to cost savings. In addition, nanotechnology is effectively applied in the preparation of such drugs as they are in nm sizes, considered one of the earliest cutoff values for the production of products utilized in nanotechnology. Early concepts described gold nanoshells as one of the successful therapies for cancer and associated diseases where the benefits of nanomedicine include effective active or passive targeting. Common medicines are degraded at a higher rate, whereas the degradation of macromolecules is time-consuming. All of the discussed properties are responsible for executing the physiological behaviors occurring at the following scale, depending on the geometry. Finally, large nanomaterials based on organic, lipid, inorganic, protein, and synthetic polymers have also been utilized to develop novel cancer cures

Impact of Nutrition Education on Knowledge, Attitude, and Practices of School-Going Adolescents of Public and Private Schools Regarding Healthy Lifestyle

Background Nutrition plays an important role in the development of people and in the prevention of disease. Nutrition education is an essential element of health awareness. Objective The study is aimed to assess the impact of nutrition education on the lifestyle of school-age adolescents and to compare the impact of nutrition education on the lifestyle of female adolescents among private and public schools. Methodology A quasi-experimental study was conducted on 108 female adolescents by using a cluster sampling technique. 54 students of ages between 10-15 years old were selected from private school, and 54 students of ages between 10-15 years old were from government school. The study duration was 6 weeks. A self-constructed pre-test questionnaire was filled by the participants. Nutrition education was given to students in the time period of 4 weeks. Lectures and brochures were developed and delivered to the students. Quizzes were taken for the evaluation and a better understanding of the respective lecture. Visual display on different parameters of a healthy lifestyle was shown on a projector. Post-test questionnaires were filled 1 week after giving 11 lectures on a healthy lifestyle. Results Results showed that there were significant associations between knowledge, attitude, and practices of government and private school (p=0.001), (p=0.005) and (p=0.001). There was a significant association (p=0.001) between pre and post knowledge, attitudes, and practices of school students. Conclusions: Lack of knowledge was the reason for inappropriate dietary habits and poor lifestyle among school-going female adolescents. Positive modifications regarding lifestyle activities had a significant association with nutrition education among school-going female adolescents

Elevated Soluble Galectin-3 as a Marker of Chemotherapy Efficacy in Breast Cancer Patients: A Prospective Study

Purpose. Galectin-3 (Gal-3) is a glycan-binding lectin with a debated role in cancer progression due to its various functions and patterns of expression. The current study investigates the relationship between breast cancer prognosis and secreted Gal-3. Methods. Breast cancer patients with first time cancer diagnosis and no prior treatment (n=88) were placed in either adjuvant or neoadjuvant setting based on their treatment modality. Stromal and plasma Gal-3 levels were measured in each patient at the time of diagnosis and then throughout treatment using immunohistochemistry (IHC) and ELISA, respectively. Healthy women (\u3e18 years of age, n=63) were used to establish baseline levels of plasma Gal-3. Patients were followed for 84 months for disease-free survival analysis. Results. Enhanced levels of plasma (adjuvant) and stromal (neoadjuvant) Gal-3 were found to be markers of chemotherapy efficacy. The patients with chemotherapy-induced increase in extracellular Gal-3 had longer disease-free interval and significantly lower rate of recurrence during 84-month follow-up compared to patients with unchanged or decreased secretion. Conclusion. The findings support the use of plasma Gal-3 as a marker for chemotherapy efficacy when no residual tumor is visible through imaging. Furthermore, stromal levels in any remaining tumors postchemotherapy can also be used to predict long-term prognosis in patients

Sensor characterization for the ULTRASAT space telescope

The Ultraviolet Transient Astronomical Satellite (ULTRASAT) is a scientific space mission carrying an astronomical telescope. The mission is led by the Weizmann Institute of Science (WIS) in Israel and the Israel Space Agency (ISA), while the camera in the focal plane is designed and built by Deutsches Elektronen Synchrotron (DESY) in Germany. Two key science goals of the mission are the detection of counterparts to gravitational wave sources and supernovae.$^1$ The launch to geostationary orbit is planned for 2024. The telescope with a field-of-view of ≈ 200 deg$^2$, is optimized to work in the near-ultraviolet (NUV) band between 220 and 280 nm. The focal plane array is composed of four 22:4-megapixel, backside-illuminated (BSI) CMOS sensors with a total active area of 90 x 90mm$^2$.$^2$ Prior to sensor production, smaller test sensors have been tested to support critical design decisions for the final flight sensor. These test sensors share the design of epitaxial layer and antireflective coatings with the flight sensors. Here, we present a characterization of these test sensors. Dark current and read noise are characterized as a function of the device temperature. A temperature-independent noise level is attributed to on-die infrared emission and the read-out electronics' self-heating. We utilize a high-precision photometric calibration setup$^3$ to obtain the test sensors' quantum efficiency relative to PTB/NIST-calibrated transfer standards (220-1100 nm), the quantum yield for $λ$ >300 nm, the non-linearity of the system, and the conversion gain. The uncertainties are discussed in the context of the newest results on the setup's performance parameters. From the three ARC options Tstd, T1 and T2, the last assists the out-of-band rejection and peaks in the mid of the ULTRASAT operational waveband. We recommend ARC option T2 for the final ULTRASAT UV sensor