Impact of air pollution on global burden of disease in 2019

Air pollution consisting of ambient air pollution and household air pollution (HAP) threatens health globally. Air pollution aggravates the health of vulnerable people such as infants, children, women, and the elderly as well as people with chronic diseases such as cardiorespiratory illnesses, little social support, and poor access to medical services. This study is aimed to estimate the impact of air pollution on global burden of disease (GBD). We extracted data about mortality and disability adjusted life years (DALYs) attributable to air pollution from 1990 to 2019. The extracted data were then organized and edited into a usable format using STATA version 15. Furthermore, we also estimated the impacts for three categories based on their socio-demographic index (SDI) as calculated by GBD study. The impacts of air pollution on overall burden of disease by SDI, gender, type of pollution, and type of disease is estimated and their trends over the period of 1990 to 2019 are presented. The attributable burden of ambient air pollution is increasing over the years while attributable burden of HAP is declining over the years, globally. The findings of this study will be useful for evidence-based planning for prevention and control of air pollution and reduction of burden of disease from air pollution at global, regional, and national levels

Effects of climatic factors on diarrheal diseases among children below 5 years of age at national and subnational levels in Nepal: an ecological study

INTRODUCTION: The incidence of diarrhea, a leading cause of morbidity and mortality in low-income countries such as Nepal, is temperature-sensitive, suggesting it could be associated with climate change. With climate change fueled increases in the mean and variability of temperature and precipitation, the incidence of water and food-borne diseases are increasing, particularly in sub-Saharan Africa and South Asia. This national-level ecological study was undertaken to provide evidence linking weather and climate with diarrhea incidence in Nepal. METHOD: We analyzed monthly diarrheal disease count and meteorological data from all districts, spanning 15 eco-development regions of Nepal. Meteorological data and monthly data on diarrheal disease were sourced, respectively, from the Department of Hydrology and Meteorology and Health Management Information System (HMIS) of the Government of Nepal for the period from 2002 to 2014. Time-series log-linear regression models assessed the relationship between maximum temperature, minimum temperature, rainfall, relative humidity, and diarrhea burden. Predictors with p-values < 0.25 were retained in the fitted models. RESULTS: Overall, diarrheal disease incidence in Nepal significantly increased with 1 degrees C increase in mean temperature (4.4%; 95% CI: 3.95, 4.85) and 1 cm increase in rainfall (0.28%; 95% CI: 0.15, 0.41). Seasonal variation of diarrheal incidence was prominent at the national level (11.63% rise in diarrheal cases in summer (95% CI: 4.17, 19.61) and 14.5% decrease in spring (95% CI: -18.81, -10.02) compared to winter season). Moreover, the effects of temperature and rainfall were highest in the mountain region compared to other ecological regions of Nepal. CONCLUSION: Our study provides empirical evidence linking weather factors and diarrheal disease burden in Nepal. This evidence suggests that additional climate change could increase diarrheal disease incidence across the nation. Mountainous regions are more sensitive to climate variability and consequently the burden of diarrheal diseases. These findings can be utilized to allocate necessary resources and envision a weather-based early warning system for the prevention and control of diarrheal diseases in Nepal

Brokering justice: global indigenous rights and struggles over hydropower in Nepal

This article explores the dynamics of brokerage at the intersection between the justice conceptions enshrined in global norms and the notions of justice asserted in specific socio-environmental struggles. Using the case of a small hydropower project in Nepal, we trace the attempts of an indigenous activist to enrol villagers in his campaign against the background of villagers’ everyday negotiations with the hydropower company. The study shows how global norms, such as indigenous peoples’ rights, may fail to gain traction on the ground or even become sources of injustice in particular contexts

Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study.

OBJECTIVE: This study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal. STUDY DESIGN: The study was a nationwide population-based cross-sectional study. SETTING AND PARTICIPANTS: Cross-sectional survey conducted in a nationally representative sample of 12 109 Nepalese adult from 2016 to 2018 on selected chronic non-communicable diseases was examined. Multistage cluster sampling with a mix of probability proportionate to size and systematic random sampling was used for the selection of individuals aged 20 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome in this study was population-based prevalence of CKD in Nepal. A participant was considered to have CKD if the urine albumin-to-creatinine ratio was greater than or equal to 30 mg/g and/or estimated glomerular filtration rate is less than 60 mL/min/1.73 m2 at baseline and in follow-up using modification of diet in renal disease study equations. The secondary outcome measure was factors associated with CKD in Nepal. The covariate adjusted association of risk factors and CKD was calculated using multivariable binary logistic regression. RESULTS: The overall prevalence of CKD in Nepal was 6.0% (95% CI 5.5 to 6.6). Factors independently associated with CKD included older age (adjusted OR (AOR) 2.6, 95% CI 1.9 to 3.6), Dalit caste (AOR 1.6, 95% CI 1.1 to 2.3), hypertension (AOR 2.4, 95% CI 2.0 to 3.0), diabetes mellitus (AOR 3.2, 95% CI 2.5 to 4.1), raised total cholesterol (AOR 1.3, 95% CI 1.0 to 1.6) and increased waist-to-hip ratio (AOR 1.6, 95% CI 1.2 to 2.3). CONCLUSION: This nationally representative study shows that the prevalence of CKD in the adult population of Nepal is substantial, and it is independently associated with several cardiometabolic traits. These findings warrant longitudinal studies to identify the causes of CKD in Nepal and effective strategies to prevent it

Peer-to-Peer energy trading in micro/mini-grids for local energy communities: A review and case study of Nepal

Distributed Energy Resources (DERs) are being integrated into the power market by customers rather than large scale energy suppliers, thereby slowly transforming the centralized, unidirectional market to a decentralized, bidirectional market and transitioning customers into prosumers. Various system architectures are used in the real field to coordinate the energy distribution in the micro/ mini-grids integrated with DERs, all of which have their strengths, weaknesses and challenges. Peer-to-peer (P2P) is an emerging architecture in the field of electrical energy trading and Distributed Generation (DG) management that can be applied in local energy markets. This paper focuses on P2P energy trading, with an in-depth discussion on its various operating algorithms, their principles, characteristics, features and scope through state of art review on P2P. Furthermore, the energy system of Nepal is used as a case study in this paper, and the micro/mini-grids of Nepal and their associated challenges, constraints and opportunities for improvement are discussed. Finally, an energy trading model is proposed to address the problems occurring in the specific case of Nepalese energy market

Quaternary time scales for the Pontocaspian domain: interbasinal connectivity and faunal evolution

The Pontocaspian (Black Sea - Caspian Sea) region has a very dynamic history of basin development and biotic evolution. The region is the remnant of a once vast Paratethys Sea. It contains some of the best Eurasian geological records of tectonic, climatic and paleoenvironmental change. The Pliocene-Quaternary co-evolution of the Black Sea-Caspian Sea is dominated by major changes in water (lake and sea) levels resulting in a pulsating system of connected and isolated basins. Understanding the history of the region, including the drivers of lake level and faunal evolution, is hampered by indistinct stratigraphic nomenclature and contradicting time constraints for regional sedimentary successions. In this paper we review and update the late Pliocene to Quaternary stratigraphic framework of the Pontocaspian domain, focusing on the Black Sea Basin, Caspian Basin, Marmara Sea and the terrestrial environments surrounding these large, mostly endorheic lake-sea systems

Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography

OBJECTIVE: The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. MATERIAL AND METHODS: Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. RESULTS: Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. CONCLUSIONS: Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation

Mental health training for community maternity workers in Nepal

Background: Mental health is a difficult topic to discuss in Nepal. This makes it hard for front-line maternity-care providers to start a discussion about mental health issues with women. As Nepal has not yet recognised midwifery as a profession, this UK-funded programme (THET) aims to train community health workers i.e. Auxiliary Nurse Midwives (ANMs) on mental health issues related to pregnancy. Purpose/Objective: This needs assessment, of all ANMs working in one district, assesses knowledge of perinatal mental health issues and future training needs. Method: This quantitative study used a structure questionnaire in Nepali at the start of the training of ANMs. The questions covered knowledge, views on mental health and illness and previous training on the topic. Ethical approval was granted by the Nepal Health Research Council (NHRC). Key Findings: In total 74 questionnaires were returned (out of 76). With 97% of ANMSs reporting they never had specific training issues around perinatal mental health. Their knowledge on perinatal mental health is poor, half of them are not aware that pregnancy and childbirth can cause mental illness. People do not talk openly about mental health problem in their local community. Most ANM thought specialised training on perinatal mental health would be useful. Discussion: Mental health in pregnancy/childbirth is often ignored especially in low-income countries like Nepal. In a country without recognised midwives there is a great need to improve attitudes and skills among community-based maternity workers who lacking training on maternity-related mental health issues. There is a great need for a national curriculum to facilitate relevant training

Enabling large-scale design, synthesis and validation of small molecule protein-protein antagonists

Although there is no shortage of potential drug targets, there are only a handful known low-molecular-weight inhibitors of protein-protein interactions (PPIs). One problem is that current efforts are dominated by low-yield high-throughput screening, whose rigid framework is not suitable for the diverse chemotypes present in PPIs. Here, we developed a novel pharmacophore-based interactive screening technology that builds on the role anchor residues, or deeply buried hot spots, have in PPIs, and redesigns these entry points with anchor-biased virtual multicomponent reactions, delivering tens of millions of readily synthesizable novel compounds. Application of this approach to the MDM2/p53 cancer target led to high hit rates, resulting in a large and diverse set of confirmed inhibitors, and co-crystal structures validate the designed compounds. Our unique open-access technology promises to expand chemical space and the exploration of the human interactome by leveraging in-house small-scale assays and user-friendly chemistry to rationally design ligands for PPIs with known structure. © 2012 Koes et al